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Al-Beltagi M, Saeed NK, Bediwy AS, Elbeltagi R. Breaking the cycle: Psychological and social dimensions of pediatric functional gastrointestinal disorders. World J Clin Pediatr 2025; 14:103323. [DOI: 10.5409/wjcp.v14.i2.103323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2024] [Revised: 12/14/2024] [Accepted: 01/02/2025] [Indexed: 03/18/2025] Open
Abstract
BACKGROUND Functional gastrointestinal disorders (FGIDs) in children present with chronic symptoms like abdominal pain, diarrhea, and constipation without identifiable structural abnormalities. These disorders are closely linked to gut-brain axis dysfunction, altered gut microbiota, and psychosocial stress, leading to psychiatric comorbidities such as anxiety, depression, and behavioral issues. Understanding this bidirectional relationship is crucial for developing effective, holistic management strategies that address physical and mental health.
AIM To examine the psychiatric impacts of FGIDs in children, focusing on anxiety and depression and their association with other neurodevelopmental disorders of childhood, such as attention-deficit/hyperactivity disorder, emphasizing the role of the gut-brain axis, emotional dysregulation, and psychosocial stress. Key mechanisms explored include neurotransmitter dysregulation, microbiota imbalance, central sensitization, heightening stress reactivity, emotional dysregulation, and symptom perception. The review also evaluates the role of family dynamics and coping strategies in exacerbating FGID symptoms and contributing to psychiatric conditions.
METHODS A narrative review was conducted using 328 studies sourced from PubMed, Scopus, and Google Scholar, covering research published over the past 20 years. Inclusion criteria focused on studies examining FGID diagnosis, gut-brain mechanisms, psychiatric comorbidities, and psychosocial factors in pediatric populations. FGIDs commonly affecting children, including functional constipation, abdominal pain, irritable bowel syndrome, gastroesophageal reflux, and cyclic vomiting syndrome, were analyzed concerning their psychological impacts.
RESULTS The review highlights a strong connection between FGIDs and psychiatric symptoms, mediated by gut-brain axis dysfunction, dysregulated microbiota, and central sensitization. These physiological disruptions increase children’s vulnerability to anxiety and depression, while psychosocial factors - such as chronic stress, early-life trauma, maladaptive family dynamics, and ineffective coping strategies - intensify the cycle of gastrointestinal and emotional distress.
CONCLUSION Effective management of FGIDs requires a biopsychosocial approach integrating medical, psychological, and dietary interventions. Parental education, early intervention, and multidisciplinary care coordination are critical in mitigating long-term psychological impacts and improving both gastrointestinal and mental health outcomes in children with FGIDs.
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Affiliation(s)
- Mohammed Al-Beltagi
- Department of Paediatrics, Faculty of Medicine, Tanta University, Tanta 31511, Alghrabia, Egypt
- Department of Pediatric, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama 26671, Bahrain
| | - Nermin K Saeed
- Medical Microbiology Section, Department of Pathology, Salmaniya Medical Complex, Governmental Hospitals, Manama 26671, Bahrain
- Medical Microbiology Section, Department of Pathology, The Royal College of Surgeons in Ireland - Bahrain, Busaiteen 15503, Muharraq, Bahrain
| | - Adel S Bediwy
- Department of Pulmonology, Faculty of Medicine, Tanta University, Tanta 31527, Alghrabia, Egypt
- Department of Pulmonology, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama 26671, Bahrain
| | - Reem Elbeltagi
- Department of Medicine, Royal College of Surgeons in Ireland - Bahrain, Busaiteen 15503, Muharraq, Bahrain
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Fu Z, Feng B, Akogo HY, Ma J, Liu Y, Quan H, Zhang X, Hou Y, Zhang X, Ma J, Cui H. Amyotrophic Lateral Sclerosis and Parkinson's Disease: Brain Tissue Transcriptome Analysis Reveals Interactions. Mol Neurobiol 2025; 62:6383-6396. [PMID: 39792201 DOI: 10.1007/s12035-024-04681-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 12/20/2024] [Indexed: 01/12/2025]
Abstract
This study utilises amyotrophic lateral sclerosis (ALS) and Parkinson's disease (PD) human brain samples from the GEO database and employs differential expression gene (DEG) analysis to identify genes that are pivotal in both neurodegenerative diseases. Through in depth GO and KEGG enrichment analyses, we elucidated the biological functions and potential pathways associated with these DEGs. Furthermore, by constructing protein‒protein interaction networks, we highlight the significance of shared DEGs in both cellular physiology and disease contexts. Analysis of drug‒gene associations revealed potential therapeutic compounds linked to ALS and PD treatment. Additionally, we explored the interactions between transcription factors, miRNAs, and common DEGs, revealing aspects of gene regulatory networks. This study provides insights into the molecular mechanisms of ALS and PD, offering valuable contributions to ongoing research and potential therapeutic avenues.
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Affiliation(s)
- Zewei Fu
- Hebei Medical University-Galway University Stem Cell Research Center, Hebei Medical University, Shijiazhuang, 050017, Hebei Province, China
- Hebei Research Center for Stem Cell Medical Translational Engineering, Shijiazhuang, 050017, Hebei Province, China
- Hebei Technology Innovation Center for Stem Cell and Regenerative Medicine, Shijiazhuang, 050017, Hebei Province, China
- Hebei International Joint Research Center for Stem Cell and Regenerative Medicine, Shijiazhuang, 050017, Hebei Province, China
| | - Baofeng Feng
- Hebei Medical University-Galway University Stem Cell Research Center, Hebei Medical University, Shijiazhuang, 050017, Hebei Province, China
- Hebei Research Center for Stem Cell Medical Translational Engineering, Shijiazhuang, 050017, Hebei Province, China
- Hebei Technology Innovation Center for Stem Cell and Regenerative Medicine, Shijiazhuang, 050017, Hebei Province, China
- Hebei International Joint Research Center for Stem Cell and Regenerative Medicine, Shijiazhuang, 050017, Hebei Province, China
- Department of Biomedical Sciences, College of Health and Allied Sciences, University of Cape Coast, PMB UCC, Cape Coast, Ghana
| | - Herman Yao Akogo
- Hebei Medical University-Galway University Stem Cell Research Center, Hebei Medical University, Shijiazhuang, 050017, Hebei Province, China
- Hebei Research Center for Stem Cell Medical Translational Engineering, Shijiazhuang, 050017, Hebei Province, China
- Hebei Technology Innovation Center for Stem Cell and Regenerative Medicine, Shijiazhuang, 050017, Hebei Province, China
- Hebei International Joint Research Center for Stem Cell and Regenerative Medicine, Shijiazhuang, 050017, Hebei Province, China
- Human Anatomy Department, Hebei Medical University, Shijiazhuang, 050017, Hebei Province, China
| | - Jiajia Ma
- Hebei Medical University-Galway University Stem Cell Research Center, Hebei Medical University, Shijiazhuang, 050017, Hebei Province, China
- Hebei Research Center for Stem Cell Medical Translational Engineering, Shijiazhuang, 050017, Hebei Province, China
- Hebei Technology Innovation Center for Stem Cell and Regenerative Medicine, Shijiazhuang, 050017, Hebei Province, China
- Hebei International Joint Research Center for Stem Cell and Regenerative Medicine, Shijiazhuang, 050017, Hebei Province, China
| | - Yukun Liu
- Hebei Medical University-Galway University Stem Cell Research Center, Hebei Medical University, Shijiazhuang, 050017, Hebei Province, China
- Hebei Research Center for Stem Cell Medical Translational Engineering, Shijiazhuang, 050017, Hebei Province, China
- Hebei Technology Innovation Center for Stem Cell and Regenerative Medicine, Shijiazhuang, 050017, Hebei Province, China
- Hebei International Joint Research Center for Stem Cell and Regenerative Medicine, Shijiazhuang, 050017, Hebei Province, China
| | - Hezhi Quan
- Hebei Medical University-Galway University Stem Cell Research Center, Hebei Medical University, Shijiazhuang, 050017, Hebei Province, China
- Hebei Research Center for Stem Cell Medical Translational Engineering, Shijiazhuang, 050017, Hebei Province, China
- Hebei Technology Innovation Center for Stem Cell and Regenerative Medicine, Shijiazhuang, 050017, Hebei Province, China
- Hebei International Joint Research Center for Stem Cell and Regenerative Medicine, Shijiazhuang, 050017, Hebei Province, China
| | - Xiaohan Zhang
- Hebei Medical University-Galway University Stem Cell Research Center, Hebei Medical University, Shijiazhuang, 050017, Hebei Province, China
- Hebei Research Center for Stem Cell Medical Translational Engineering, Shijiazhuang, 050017, Hebei Province, China
- Hebei Technology Innovation Center for Stem Cell and Regenerative Medicine, Shijiazhuang, 050017, Hebei Province, China
- Hebei International Joint Research Center for Stem Cell and Regenerative Medicine, Shijiazhuang, 050017, Hebei Province, China
| | - Yu Hou
- Hebei Medical University-Galway University Stem Cell Research Center, Hebei Medical University, Shijiazhuang, 050017, Hebei Province, China
- Hebei Research Center for Stem Cell Medical Translational Engineering, Shijiazhuang, 050017, Hebei Province, China
- Hebei Technology Innovation Center for Stem Cell and Regenerative Medicine, Shijiazhuang, 050017, Hebei Province, China
- Hebei International Joint Research Center for Stem Cell and Regenerative Medicine, Shijiazhuang, 050017, Hebei Province, China
| | - Xuecong Zhang
- Hebei Medical University-Galway University Stem Cell Research Center, Hebei Medical University, Shijiazhuang, 050017, Hebei Province, China
- Hebei Research Center for Stem Cell Medical Translational Engineering, Shijiazhuang, 050017, Hebei Province, China
- Hebei Technology Innovation Center for Stem Cell and Regenerative Medicine, Shijiazhuang, 050017, Hebei Province, China
- Hebei International Joint Research Center for Stem Cell and Regenerative Medicine, Shijiazhuang, 050017, Hebei Province, China
| | - Jun Ma
- Hebei Medical University-Galway University Stem Cell Research Center, Hebei Medical University, Shijiazhuang, 050017, Hebei Province, China.
- Hebei Research Center for Stem Cell Medical Translational Engineering, Shijiazhuang, 050017, Hebei Province, China.
- Hebei Technology Innovation Center for Stem Cell and Regenerative Medicine, Shijiazhuang, 050017, Hebei Province, China.
- Hebei International Joint Research Center for Stem Cell and Regenerative Medicine, Shijiazhuang, 050017, Hebei Province, China.
- Department of Biomedical Sciences, College of Health and Allied Sciences, University of Cape Coast, PMB UCC, Cape Coast, Ghana.
| | - Huixian Cui
- Hebei Medical University-Galway University Stem Cell Research Center, Hebei Medical University, Shijiazhuang, 050017, Hebei Province, China
- Hebei Research Center for Stem Cell Medical Translational Engineering, Shijiazhuang, 050017, Hebei Province, China
- Hebei Technology Innovation Center for Stem Cell and Regenerative Medicine, Shijiazhuang, 050017, Hebei Province, China
- Hebei International Joint Research Center for Stem Cell and Regenerative Medicine, Shijiazhuang, 050017, Hebei Province, China
- Department of Biomedical Sciences, College of Health and Allied Sciences, University of Cape Coast, PMB UCC, Cape Coast, Ghana
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Akbari R, Salimi Y, Dehghani-Aarani F, Rezayat E. Attention in irritable bowel syndrome: A systematic review of affected domains and brain-gut axis interactions. J Psychosom Res 2025; 191:112067. [PMID: 40048890 DOI: 10.1016/j.jpsychores.2025.112067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2025] [Revised: 01/29/2025] [Accepted: 02/17/2025] [Indexed: 03/16/2025]
Abstract
BACKGROUND Irritable bowel syndrome (IBS) is a disorder characterized by gut-brain interactions, leading to abdominal pain and altered stool patterns, which significantly affect patients' quality of life. Recent research suggests that attention may be impaired in individuals with IBS, potentially influencing symptom perception and emotional distress. OBJECTIVE This systematic review aims to examine the relationship between attention and IBS, focusing on the affected domains of attention and the interactions within the brain-gut axis. METHODS A comprehensive search was conducted across MEDLINE/PubMed, PsychINFO, and Scopus from January 1990 to December 2024. Studies included were those that assessed attention in adult IBS patients using valid measurement tools. A total of 24 studies were analyzed, incorporating neuroimaging and behavioral methods. RESULTS IBS individuals exhibit specific attentional impairments, including deficits in sustained attention, selective attentional biases toward gastrointestinal (GI)-related and symptom-specific stimuli, and heightened vigilance to threat and pain cues. Neurofunctional studies reveal altered brain activity in areas such as the insula, anterior cingulate cortex, and amygdala, indicating increased interoceptive awareness and cognitive load. Pre-attentive processing and sensory gating show exaggerated responses, while sustained attention and attentional control demand additional cognitive resources. These patterns reflect an interplay between heightened sensitivity to internal stimuli and cognitive processing challenges in IBS. CONCLUSION This review highlights specific attentional deficits and biases in IBS, suggesting they may contribute to symptom exacerbation and emotional distress. Further research is needed to explore the underlying mechanisms and potential therapeutic interventions.
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Affiliation(s)
- Reyhaneh Akbari
- Department of Psychology, Faculty of Psychology and Education, University of Tehran, Tehran, Iran
| | - Yeganeh Salimi
- Department of Cognitive Sciences, Faculty of Psychology and Education, University of Tehran, Tehran, Iran
| | - Fateme Dehghani-Aarani
- Department of Psychology, Faculty of Psychology and Education, University of Tehran, Tehran, Iran.
| | - Ehsan Rezayat
- Department of Cognitive Sciences, Faculty of Psychology and Education, University of Tehran, Tehran, Iran; School of Cognitive Sciences, Institute for Research in Fundamental Sciences (IPM), Niavaran, Tehran, Iran.
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Santos J, Maran PL, Rodríguez-Urrutia A. Stress, microbiota, and the gut-brain axis in mental and digestive health. Med Clin (Barc) 2025; 164:295-304. [PMID: 39824687 DOI: 10.1016/j.medcli.2024.11.023] [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: 08/19/2024] [Revised: 11/26/2024] [Accepted: 11/27/2024] [Indexed: 01/20/2025]
Abstract
The prevailing mind-body dualism in contemporary medicine, rooted in reductionism and the fragmentation of knowledge, has impeded the development of a conceptual model that can adequately address the complexity of illnesses. Integrating biomedical data into a cohesive model that considers the mind-body-context interconnections is essential. This integration is not merely theoretical; rather, it has significant clinical implications. This is exemplified by chronic stress-related mental and digestive disorders. The onset and development of these disorders are intimately linked to chronic psychological stress via the brain-gut-microbiota axis. The present article examines the evidence and mechanisms indicating that stress is a primary factor and a potentiator of symptom severity in common mental health and digestive diseases, with a particular focus on human studies. However, due to space limitations, only a very general overview of preventive and therapeutic clinical strategies is provided. It is hoped that the recurring phrase, "Everything that happens to you is due to stress," will become more comprehensible to the physician after reading this manuscript.
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Affiliation(s)
- Javier Santos
- Gastroenterology Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Hospital Campus, Barcelona, Spain; Digestive Physiology and Physiopathology Research Group, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain; Centro de Investigación Biomédica en Red, Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain.
| | - Patricia Laura Maran
- Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Amanda Rodríguez-Urrutia
- Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Treatment-Resistant Depression Programme, The Brain-Inmune-Gut Unit, Mental Health Department, Vall d'Hebron Hospital Campus, Barcelona, Spain; Centro de Investigación Biomédica en Red, Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
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5
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Baghdadi G, Feyzpour M, Shahrokhi SA, Amiri R, Rahimlou M. The association between the Mediterranean Diet and the prime diet quality score and new-diagnosed irritable bowel syndrome: a matched case-control study. Front Med (Lausanne) 2025; 12:1529374. [PMID: 40144876 PMCID: PMC11936948 DOI: 10.3389/fmed.2025.1529374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2024] [Accepted: 02/19/2025] [Indexed: 03/28/2025] Open
Abstract
Background Irritable bowel syndrome (IBS) is a prevalent functional gastrointestinal disorder with multifactorial etiology. Dietary patterns, including the Mediterranean Diet (Med-Diet) and the Prime Diet Quality Score (PDQS), may play a role in IBS risk. This study examined the association between adherence to the Med-Diet and PDQS and new-diagnosed IBS in an Iranian population. Methods A matched case-control study was conducted on 170 newly diagnosed IBS patients and 340 age- and sex-matched controls recruited from outpatient clinics in Zanjan, Iran. Dietary intake was assessed using a semiquantitative food frequency questionnaire. The Med-Diet score and PDQS were calculated, with higher scores indicating better diet quality. Conditional logistic regression was used to determine the odds of IBS across quartiles of Med-Diet and PDQS, adjusting for sociodemographic and clinical factors. Results Higher adherence to the Med-Diet was associated with 51% lower odds of IBS (OR: 0.49; 95% CI: 0.30-0.73, P < 0.001) in the highest quartile compared to the lowest. Similarly, participants in the highest PDQS quartile showed a significantly 59% lower odds of IBS (OR: 0.41; 95% CI: 0.26-0.51, P < 0.001) compared to the lowest quartile. Both associations remained significant after adjusting for potential confounders, including total energy intake. These findings highlight the potential clinical relevance of dietary quality in IBS prevention. Conclusion Higher adherence to the Med-Diet and a higher PDQS were both inversely associated with IBS risk. Specifically, individuals with higher Med-Diet scores and higher PDQS scores had a lower risk of developing IBS compared to those with lower adherence or scores. These findings suggest a potential role of these dietary patterns in modulating IBS risk, although causal relationships cannot be established from this study.
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Affiliation(s)
| | | | | | | | - Mehran Rahimlou
- Department of Nutrition, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran
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Bohl B, Lei Y, Bewick GA, Hashemi P. Measurement of Real-Time Serotonin Dynamics from Human-Derived Gut Organoids. Anal Chem 2025; 97:5057-5065. [PMID: 40007472 PMCID: PMC11912129 DOI: 10.1021/acs.analchem.4c06033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2024] [Revised: 01/30/2025] [Accepted: 02/04/2025] [Indexed: 02/27/2025]
Abstract
The importance of the gut in regulating the brain-body immune axis is becoming increasingly evident. Interestingly, the brain and gut share many common signaling molecules, with serotonin being one of the most notable. In fact, the gut is the primary source of serotonin in the body. However, studying serotonin dynamics in a human-specific context remains a challenge. Human stem cell-derived models provide a promising avenue for studying signal transmission in well-controlled, in vitro environments. In this study, we report the first fast-scan cyclic voltammetry (FSCV) measurements of serotonin signaling in a newly developed enterochromaffin cell (ECC)-enriched gut organoid model. First, we characterize the stem cell-derived gut organoids and confirm they are enriched with ECCs, the key cell type responsible for producing and releasing serotonin in the gut. We then optimize an in vitro buffer that maintains cell viability while supporting FSCV measurements. Using this system, we detect spontaneous release events, which increase in frequency and amplitude following stimulation with forskolin (FSK) and 3-isobutyl-1-methylxanthine (IBMX). Finally, we confirm the identity of the signal as serotonin using a selective serotonin reuptake inhibitor (SSRI), which significantly delayed the reuptake profile. Our study introduces the first real-time measurement of serotonin signaling in a human-derived gut model. We believe this system will be essential for future research on serotonin's role in the gut and for potential novel drug target identification.
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Affiliation(s)
- Bettina Bohl
- Department
of Bioengineering, Imperial College London, South Kensington, London SW72AZ, United Kingdom
| | - Yuxian Lei
- Diabetes
and Obesity Theme, School of Cardiovascular and Metabolic Medicine
and Sciences, Faculty of Life Sciences and Medicine, King’s College London, London SE1 1UL, United Kingdom
| | - Gavin A. Bewick
- Diabetes
and Obesity Theme, School of Cardiovascular and Metabolic Medicine
and Sciences, Faculty of Life Sciences and Medicine, King’s College London, London SE1 1UL, United Kingdom
- Diabetes
Endocrinology and Obesity Clinical academic Partnership Kings Health
Partners, London SE1 9RT, United Kingdom
| | - Parastoo Hashemi
- Department
of Bioengineering, Imperial College London, South Kensington, London SW72AZ, United Kingdom
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Abdelnaim MA, Hebel T, Lang-Hambauer V, Schlaier J, Langguth B, Reissmann A. Deep brain stimulation for obsessive compulsive disorder leads to symptom changes of comorbid irritable bowel syndrome. Front Psychiatry 2025; 16:1545318. [PMID: 40109436 PMCID: PMC11919902 DOI: 10.3389/fpsyt.2025.1545318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2024] [Accepted: 02/17/2025] [Indexed: 03/22/2025] Open
Abstract
Introduction Irritable bowel syndrome (IBS) is a common condition characterized by abdominal pain and altered bowel habits, affecting around 11% of individuals globally. It is linked to dysregulation of the brain-gut axis, with altered activity and connectivity in various brain regions. IBS patients often have psychiatric comorbidities like anxiety, or obsessive-compulsive disorder (OCD). Deep brain stimulation (DBS) is an established treatment option for severe, therapy-refractory OCD. It has been suggested that DBS for OCD could also have a beneficial effect on accompanying IBS-symptoms. Methods and patients Nine patients with treatment-refractory OCD who underwent DBS in the bed nucleus striae terminalis (BNST) have been included in this study (4 males, 5 females, mean age: 39.1 ± 11.5 years). Patients were examined with the Gastrointestinal Symptom Rating Scale for Irritable Bowel Syndrome (GSRS-IBS) as well as the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) both before the beginning of DBS as well as throughout several follow-up visits for 12 months following the start of DBS. Results Three patients displayed clinically relevant levels of IBS-symptoms at baseline (GSRS-IBS scores at or beyond 32). All of those three patients showed a reduction of the GSRS-IBS score at the last follow-up (12-40%). For the other 6 patients, 5 of them showed also a reduction of the GSRS-IBS compared to the score at baseline. The mean score for all patients showed a descriptive trend toward score reduction throughout the study period and until the last follow up visit after 12 months. The mean Y-BOCS decreased from 31.11 at baseline to 16.50 at the last follow-up. Out of the 9 patients, 7 (78%) were considered responders with Y-BOCS scores decreasing between 37% to 74%. Moderate-to-large correlations between both scales could be observed at both the 9-month and the 12-month follow-up visit. However, none of these associations was statistically significant. Conclusion In this study, we found alleviation of IBS symptoms after DBS of the BNST, along with improvement in OCD symptoms. Future research using larger sample sizes should address whether the reductions are tied to the improvement of OCD symptoms or if DBS exerts positive effects on IBS independently of OCD symptoms.
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Affiliation(s)
- Mohamed A Abdelnaim
- Department of Psychiatry and Psychotherapy, University Regensburg, Regensburg, Germany
- Center for Deep Brain Stimulation, University Regensburg, Regensburg, Germany
| | - Tobias Hebel
- Department of Psychiatry and Psychotherapy, University Regensburg, Regensburg, Germany
| | - Verena Lang-Hambauer
- Center for Deep Brain Stimulation, University Regensburg, Regensburg, Germany
- Clinic and Policlinic for Psychiatry and Psychotherapy, Mainkofen, Germany
| | - Juergen Schlaier
- Center for Deep Brain Stimulation, University Regensburg, Regensburg, Germany
- Department of Neurosurgery, University Regensburg, Regensburg, Germany
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University Regensburg, Regensburg, Germany
- Center for Deep Brain Stimulation, University Regensburg, Regensburg, Germany
| | - Andreas Reissmann
- Department of Psychiatry and Psychotherapy, University Regensburg, Regensburg, Germany
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Sulaimi F, Ong TSK, Tang ASP, Quek J, Pillay RM, Low DT, Lee CKL, Siah KTH, Ng QX. Risk factors for developing irritable bowel syndrome: systematic umbrella review of reviews. BMC Med 2025; 23:103. [PMID: 39985070 PMCID: PMC11846330 DOI: 10.1186/s12916-025-03930-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2024] [Accepted: 02/06/2025] [Indexed: 02/24/2025] Open
Abstract
BACKGROUND Irritable bowel syndrome (IBS) is a debilitating disorder affecting 4-9% of the global population. It is a multifaceted disorder with complex and varied causes. This review aims to consolidate the evidence regarding IBS risk factors by examining existing systematic reviews and meta-analyses, covering potential genetic, immunological, psychological, and dietary causes. METHODS Systematic literature searches were conducted in MEDLINE, Embase and Cochrane library databases. Study selection and data extraction were conducted independently by four authors, with discrepancies resolved by consensus with a senior author. Systematic reviews examining risk factors of IBS development were eligible for review. Results were narratively synthesized. Quality of reviews were analysed using AMSTAR 2, and evidence were appraised using GRADE methodology. RESULTS A total of 69 systematic reviews were included in this study. Most reviews were of "critically low" quality, while the remaining were "low" quality. Common shortcomings included the absence of a list of excluded studies with justifications for their exclusion and inadequate consideration of the risk of bias in individual studies. Eight major categories of risk factors for IBS identified were as follows: dietary, genetic, environmental, psychological, gut microbiome, socio-economic, physiological, and pathological, albeit overlaps exist. The most frequently reported risk factors for IBS development were female gender and anxiety disorders, with overall GRADE evaluation of "low"; depression and gastroenteritis, with overall GRADE evaluation of "moderate". CONCLUSIONS Clinical practice should prioritize recognition of these risk factors. Future reviews should improve their reporting of results based on the PRISMA guidelines, to enhance the quality of research in this field. PROTOCOL REGISTRATION PROSPERO CRD42023493739.
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Affiliation(s)
- Farisah Sulaimi
- School of Medical Sciences, Wallace Wurth Building, University of New South Wales, Sydney, NSW, Australia
| | - Timothy Sheng Khai Ong
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ansel Shao Pin Tang
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jingxuan Quek
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Renish M Pillay
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Damien Tianle Low
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Charisse Kai Ling Lee
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Kewin Tien Ho Siah
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Gastroenterology & Hepatology, University Medicine Cluster, National University Hospital, Singapore, Singapore
| | - Qin Xiang Ng
- NUS Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.
- SingHealth Duke-NUS Global Health Institute, Duke-NUS Medical School, Singapore, Singapore.
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Cheng S, Xiao W, Shi F, Zhao Z, Gao X, Zhang Y, Huang H, Li F, Cao C, Han J. A Bifunctional "Two-in-One" Array for Simultaneous Diagnosis of Irritable Bowel Syndrome and Identification of Low-FODMAP Diets. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2025; 73:3772-3784. [PMID: 39785268 DOI: 10.1021/acs.jafc.4c08690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2025]
Abstract
Irritable bowel syndrome (IBS) is a globally prevalent functional gastrointestinal disorder frequently misdiagnosed due to overlapping symptoms with other diseases. Currently, there are no rapid and effective diagnostic or therapeutic approaches for IBS. Despite this, low-FODMAP diets (LFDs) have become a major dietary intervention strategy for symptom relief. However, detecting FODMAPs usually relies on chromatographic techniques, which are costly and time-consuming, making it difficult to apply in real-time detection. In this study, we introduce the first dual-functional sensor array capable of rapidly diagnosing IBS and identifying low-FODMAP diets. This six-element array was constructed using nitrophenylboronic acid-modified poly(ethylenimine) coupled with coumarins through dynamic borate ester bonds across a range of pH conditions. Optimized by diverse machine learning algorithms, with the multilayer perceptron (MLP) algorithm proving optimal, the array enabled the simultaneous identification of 12 intestinal bacteria with 99.2% accuracy and the detection of mouse fecal specimens with varying degrees of IBS with 99.8% accuracy within seconds. Furthermore, it allowed for the detection of various FODMAP levels in commercially purchased, brand-named, and differently processed soy milk. The array demonstrates potential for use in both the clinical diagnosis of IBS and the guiding of low-FODMAP diets for patients.
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Affiliation(s)
- Shujie Cheng
- State Key Laboratory of Natural Medicines, National R&D Center for Chinese Herbal Medicine Processing, School of Engineering, China Pharmaceutical University, Nanjing 210009, China
| | - Wenqi Xiao
- State Key Laboratory of Natural Medicines, National R&D Center for Chinese Herbal Medicine Processing, School of Engineering, China Pharmaceutical University, Nanjing 210009, China
| | - Fangfang Shi
- State Key Laboratory of Natural Medicines, National R&D Center for Chinese Herbal Medicine Processing, School of Engineering, China Pharmaceutical University, Nanjing 210009, China
| | - Zihao Zhao
- State Key Laboratory of Natural Medicines, National R&D Center for Chinese Herbal Medicine Processing, School of Engineering, China Pharmaceutical University, Nanjing 210009, China
| | - Xuejuan Gao
- Dian Jiang General Hospital of Chongqing, Chongqing 408300, China
| | - Yanliang Zhang
- Department of Infectious Diseases, Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing 210004, Jiangsu, China
| | - Hui Huang
- State Key Laboratory of Natural Medicines, National R&D Center for Chinese Herbal Medicine Processing, School of Engineering, China Pharmaceutical University, Nanjing 210009, China
| | - Fei Li
- State Key Laboratory of Natural Medicines, National R&D Center for Chinese Herbal Medicine Processing, School of Engineering, China Pharmaceutical University, Nanjing 210009, China
| | - Chongjiang Cao
- State Key Laboratory of Natural Medicines, National R&D Center for Chinese Herbal Medicine Processing, School of Engineering, China Pharmaceutical University, Nanjing 210009, China
| | - Jinsong Han
- State Key Laboratory of Natural Medicines, National R&D Center for Chinese Herbal Medicine Processing, School of Engineering, China Pharmaceutical University, Nanjing 210009, China
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10
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Phan TN, Tran QK, Truong XL, Nguyen THT. Anxiety and Depression Disorders in Vietnamese Patients With Irritable Bowel Syndrome: A Cross-Sectional Clinic-Based Study. JGH Open 2025; 9:e70116. [PMID: 39959452 PMCID: PMC11825372 DOI: 10.1002/jgh3.70116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 01/29/2025] [Accepted: 02/03/2025] [Indexed: 02/18/2025]
Abstract
Background Irritable bowel syndrome (IBS) is a prevalent functional gastrointestinal disorder. Growing evidence suggests a significant association between IBS and psychological problems, such as anxiety and depression. This study was conducted to assess the prevalence of anxiety and depression in Vietnamese patients diagnosed with IBS according to Rome IV criteria. Methods This cross-sectional study recruited 186 consecutive patients who underwent outpatient clinic visits and colonoscopy for gastrointestinal symptoms. IBS diagnosis was established using the validated Rome IV criteria. Anxiety and depression were assessed using a validated Vietnamese version of the Hospital Anxiety and Depression Scale (HADS). Results The mean age of IBS patients was 49.5 ± 12.0 years, with females comprising 53.8%. IBS-M was the most prevalent subtype (39.8%), followed by IBS-C (39.2%) and IBS-D (21.0%). Using the HADS cut-off of ≥ 11 points for probable anxiety and depression, the prevalence was 21.0% and 11.8%, respectively. Expanding the criterion to a HADS of ≥ 8, indicating significant symptoms, increased the prevalence to 55.9% for anxiety and 40.8% for depression disorders. Patients with IBS-C, IBS-D, or IBS-M exhibited a significantly higher risk of depressive disorders compared to those without IBS, with odds ratios of 4.261, 7.013, and 6.585, respectively (p < 0.001). Additionally, men were less likely than women to experience depressive disorders. Conclusion The findings revealed a high prevalence of depression and anxiety disorders among Vietnamese patients with IBS. Those with the IBS-M or IBS-D subtypes and a greater number of gastrointestinal symptoms were more likely to experience higher levels of depression and anxiety, particularly women.
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Affiliation(s)
- Trung Nam Phan
- Gastroenterology and Endoscopy CenterHospital of University of Medicine and Pharmacy, Hue UniversityHueVietnam
| | - Quoc Khanh Tran
- Gastroenterology and Endoscopy CenterHospital of University of Medicine and Pharmacy, Hue UniversityHueVietnam
| | - Xuan Long Truong
- Gastroenterology and Endoscopy CenterHospital of University of Medicine and Pharmacy, Hue UniversityHueVietnam
| | - Thi Huyen Thuong Nguyen
- Gastroenterology and Endoscopy CenterHospital of University of Medicine and Pharmacy, Hue UniversityHueVietnam
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11
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Mazor Y, Leach MM, Jones M, Ejova A, Fisher C, Joffe D, Roach P, Kellow J, Malcolm A. Prospective Evaluation of Autonomic Function and Intestinal Blood Flow in Health and Irritable Bowel Syndrome Shows Differences Limited to Patients With Constipation Predominance. Neurogastroenterol Motil 2025; 37:e14975. [PMID: 39627962 DOI: 10.1111/nmo.14975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Revised: 11/11/2024] [Accepted: 11/19/2024] [Indexed: 01/22/2025]
Abstract
BACKGROUND Autonomic dysfunction may contribute to symptom generation in irritable bowel syndrome (IBS), possibly driven by psychological morbidity and activation of the hypothalamic-pituitary-adrenal axis. Previous data are conflicting, perhaps due to lack of accounting for differential bowel patterns in IBS (constipation vs. diarrhea) or by diverse methodologies used to measure autonomic function. Our aim was to determine if autonomic response differed between IBS subtypes and healthy controls. METHODS Forty female volunteers (20 IBS and 20 healthy) underwent comprehensive autonomic testing, fasting and postprandially, and in response to cold pressor and deep breathing challenges. Pulse transit time (PTT) and ultrasound measurements of intestinal blood flow were used as measures of systemic and local autonomic function, respectively. Outcomes were adjusted for baseline psychological comorbidities and gastric emptying (measured concurrently with scintigraphy). KEY RESULTS Findings, confined to IBS patients with predominant constipation (IBS-C), included (1) lower fasting and a trend to larger postprandial increase in superior mesenteric artery end-diastolic velocity; (2) lower fasting PTT, suggesting higher sympathetic tone, but no difference in postprandial PTT change; and (3) attenuated increase in postprandial aortic peak systolic velocity. Response to systemic autonomic challenges did not differ between IBS and health. Some psychological factors mediated differences between groups in the fasting, but not postprandial, state. CONCLUSIONS AND INFERENCES IBS-C patients display systemic and local autonomic imbalance providing some support for recent therapies aimed at modulating autonomic state specifically in this patient group (e.g., acustimulation).
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Affiliation(s)
- Yoav Mazor
- Department of Gastroenterology, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Margaret M Leach
- Department of Gastroenterology, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Michael Jones
- School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, North Ryde, New South Wales, Australia
| | - Anastasia Ejova
- School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, North Ryde, New South Wales, Australia
| | - Charles Fisher
- Department of Vascular Surgery, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - David Joffe
- Department of Respiratory Medicine, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Paul Roach
- Department of Nuclear Medicine, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - John Kellow
- Department of Gastroenterology, Royal North Shore Hospital, St Leonards, New South Wales, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Allison Malcolm
- Department of Gastroenterology, Royal North Shore Hospital, St Leonards, New South Wales, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
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12
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Atanasova K, Knödler LL, Reindl W, Ebert MP, Thomann AK. Role of the gut microbiome in psychological symptoms associated with inflammatory bowel diseases. Semin Immunopathol 2025; 47:12. [PMID: 39870972 PMCID: PMC11772462 DOI: 10.1007/s00281-025-01036-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2024] [Accepted: 01/02/2025] [Indexed: 01/29/2025]
Abstract
The brain-gut axis constitutes the basis for the bidirectional communication between the central nervous system and the gastrointestinal tract driven by neural, hormonal, metabolic, immunological, and microbial signals. Alterations in the gut microbiome composition as observed in inflammatory bowel diseases can modulate brain function and emerging empirical evidence has indicated that interactions among the brain-gut microbiome-axis seem to play a significant role in the pathogenesis of both inflammatory bowel diseases and psychiatric disorders and their comorbidity. Yet, the immunological and molecular mechanisms underlying the co-occurrence of inflammatory bowel diseases and psychological symptoms are still poorly understood. The aim of this narrative review is to highlight contemporary empirical findings supporting a pivotal role of the gut microbiome in the pathophysiology of highly prevalent neuropsychiatric symptoms in inflammatory bowel diseases such as fatigue, depression, and anxiety. Finally, we focus on microbiome modulation as potential treatment option for comorbid neuropsychiatric symptoms in immune-mediated diseases and especially in inflammatory bowel diseases. High-quality clinical trials are required to clarify how microbiome modulation through dietary interventions or probiotic, prebiotic or synbiotic treatment can be used clinically to improve mental health and thus quality of life of patients with inflammatory bowel diseases.
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Affiliation(s)
- Konstantina Atanasova
- Department of Medicine II, Medical Faculty Mannheim, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany.
- Department of Psychosomatic Medicine, Medical Faculty Mannheim, Central Institute for Mental Health Mannheim, Heidelberg University, Mannheim, Germany.
| | - Laura-Louise Knödler
- Department of Medicine II, Medical Faculty Mannheim, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Wolfgang Reindl
- Department of Medicine II, Medical Faculty Mannheim, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Matthias Philip Ebert
- Department of Medicine II, Medical Faculty Mannheim, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Anne Kerstin Thomann
- Department of Medicine II, Medical Faculty Mannheim, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
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13
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Barbara G, Aziz I, Ballou S, Chang L, Ford AC, Fukudo S, Nurko S, Olano C, Saps M, Sayuk G, Siah KTH, Van Oudenhove L, Simrén M. Rome Foundation Working Team Report on overlap in disorders of gut-brain interaction. Nat Rev Gastroenterol Hepatol 2025:10.1038/s41575-024-01033-9. [PMID: 39870943 DOI: 10.1038/s41575-024-01033-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/18/2024] [Indexed: 01/29/2025]
Abstract
In patients with disorders of gut-brain interaction (DGBI), overlapping non-gastrointestinal conditions such as fibromyalgia, headaches, gynaecological and urological conditions, sleep disturbances and fatigue are common, as is overlap among DGBI in different regions of the gastrointestinal tract. These overlaps strongly influence patient management and outcome. Shared pathophysiology could explain this scenario, but details are not fully understood. This overlap has been shown to be of great relevance for DGBI. In addition, symptoms considered to be caused by a DGBI could have a detectable organic cause, and in patients with a diagnosed organic gastrointestinal disease, symptoms not clearly explained by the pathology defining this organic disease are common. Thus, the aims of this Rome Foundation Working Team Report were to review the literature on overlapping conditions among patients with paediatric and adult DGBI and, based on the available epidemiological and clinical evidence, make recommendations for the current diagnostic and therapeutic approach, and for future research. Specifically, we focused on other DGBI in the same or different gastrointestinal anatomical region(s), DGBI overlap with organic bowel diseases in remission, and DGBI overlap with non-gastrointestinal, non-structural conditions.
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Affiliation(s)
- Giovanni Barbara
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Imran Aziz
- Academic Department of Gastroenterology, Sheffield Teaching Hospitals, Sheffield, UK
- Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | - Sarah Ballou
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Lin Chang
- Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Alexander C Ford
- Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, UK
- Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK
| | - Shin Fukudo
- Department of Psychosomatic Medicine, Japanese Red Cross Ishinomaki Hospital, Research Center for Accelerator and Radioisotope Science, Tohoku University, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Samuel Nurko
- Center for Motility and Functional Gastrointestinal Disorders, Boston Children's Hospital, Boston, MA, USA
| | - Carolina Olano
- Gastroenterology Department. Universidad de la República, Montevideo, Uruguay
| | - Miguel Saps
- Division of Gastroenterology, Hepatology, and Nutrition, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Gregory Sayuk
- Gastroenterology Division, Washington University School of Medicine, St. Louis, MO, USA
- St. Louis Veterans Affairs Medical Center, St. Louis, MO, USA
| | - Kewin T H Siah
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Gastroenterology and Hepatology, National University Hospital, Singapore, Singapore
| | - Lukas Van Oudenhove
- Laboratory for Brain-Gut Axis Studies (LaBGAS), Translational Research in Gastrointestinal Disorders (TARGID), KU Leuven, Leuven, Belgium
- Leuven Brain Institute, KU Leuven, Leuven, Belgium
- Consultation-Liaison Psychiatry, University Psychiatric Centre KU Leuven, Leuven, Belgium
| | - Magnus Simrén
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
- Center for Functional GI and Motility Disorders, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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14
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Lei Y, Sun X, Ruan T, Lu W, Deng B, Zhou R, Mu D. Effects of Probiotics and Diet Management in Patients With Irritable Bowel Syndrome: A Systematic Review and Network Meta-analysis. Nutr Rev 2025:nuae217. [PMID: 39862384 DOI: 10.1093/nutrit/nuae217] [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] [Indexed: 01/27/2025] Open
Abstract
CONTEXT The efficacy of probiotics and diet management in irritable bowel syndrome (IBS) is controversial, and their relative effectiveness remains unclear. OBJECTIVE This study aimed to evaluate the effects of probiotics, diet management, and their combination on IBS. DATA SOURCES PubMed, Embase, Cochrane, and Web of Science were searched from inception to July 10, 2023, for relevant studies, including symptom relief, IBS-symptom severity score (-SSS), and IBS-quality of life measure (-QOL). DATA EXTRACTION Two investigators independently performed the data extraction and quality assessment. DATA ANALYSIS A network meta-analysis was performed using a frequentist approach and a random-effects model to estimate the relative risk (RR) and 95% CI. RESULTS Forty-four articles were eligible for this study. In relieving IBS symptoms, compared with a sham diet, a low-fermentable oligosaccharide, disaccharide, monosaccharide, and polyols (low-FODMAP) diet (RR: 3.22; 95% CI: 1.70-6.26) and low-FODMAP diet combined with probiotics (RR: 17.79; 95% CI: 3.27-112.54) significantly relieved IBS symptoms. The control group showed significantly lower effectiveness than the probiotics group (RR: 0.47; 95% CI: 0.32-0.69). According to the surface under the cumulative rank curve (SUCRA), a low-FODMAP diet combined with probiotics (80.4%) had the best effect in relieving IBS symptoms, followed by a low-FODMAP diet (70.8%), probiotics (65.1%), and a gluten-free diet (54.3%). In reducing the total IBS-SSS, the low-FODMAP diet (90.5%) was the most effective, followed by the low-FODMAP diet combined with probiotics (76.6%), probiotics alone (62.3%), and gluten-free diet (28.3%). In reducing total IBS-QOL, probiotics (72.1%) ranked first, followed by gluten-free (57.0%) and low-FODMAP (56.9%) diets. Probiotics (34.9%) were associated with the lowest risk of adverse effects. CONCLUSION A low-FODMAP diet combined with probiotics is most effective in relieving IBS symptoms. A low-FODMAP diet is the most recommended diet for alleviating IBS severity, and probiotics were associated with improving the QOL of patients with IBS, with the fewest adverse events. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42024499113.
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Affiliation(s)
- Yupeng Lei
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan 610041, China
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Xuemei Sun
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan 610041, China
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Tiechao Ruan
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan 610041, China
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Wenting Lu
- Integrated Care Management Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Bixin Deng
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan 610041, China
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Ruixi Zhou
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan 610041, China
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Dezhi Mu
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan 610041, China
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China
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15
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Black CJ, Ford AC. An evidence-based update on the diagnosis and management of irritable bowel syndrome. Expert Rev Gastroenterol Hepatol 2025:1-16. [PMID: 39835671 DOI: 10.1080/17474124.2025.2455586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2024] [Accepted: 01/15/2025] [Indexed: 01/22/2025]
Abstract
INTRODUCTION Irritable bowel syndrome (IBS) is a disorder of gut-brain interaction affecting 5% of the population. The cardinal symptoms are abdominal pain and altered stool form or frequency. AREAS COVERED Diagnosis and management of IBS. We searched the literature for diagnostic accuracy studies, randomized controlled trials, and meta-analyses. A positive diagnosis of IBS, alongside testing to exclude celiac disease, is recommended. Exhaustive investigation has a low yield. Patients should be offered traditional dietary advice. If response is incomplete, specialist dietetic guidance should be considered. Probiotics may be beneficial, but quality of evidence is poor. First-line treatment of constipation is with laxatives, with secretagogues used where these are ineffective. Anti-diarrheal drugs should be used first-line for diarrhea, with second-line drugs including 5-hydroxytryptamine-3 antagonists, eluxadoline, or rifaximin, where available. First-line treatment of abdominal pain should be with antispasmodics, with gut-brain neuromodulators prescribed second-line. Low-dose tricyclic antidepressants, such as amitriptyline, are preferred. Brain-gut behavioral therapies are effective and have evidence for efficacy in patients refractory to standard therapies. EXPERT OPINION Despite substantial advances, there remains scope for improvement in terms of both the diagnosis and management of IBS. Reinforcement of positive diagnostic strategies for the condition and novel treatment paradigms are required.
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Affiliation(s)
- Christopher J Black
- Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, UK
- Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK
| | - Alexander C Ford
- Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, UK
- Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK
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16
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Li M, Zhuo X, Liu Y, You J, Lin J. PPARγ activation attenuates neonatal CRD-induced visceral pain sensitization and anxiety in male rats by alleviating oxidative stress. BMC Gastroenterol 2025; 25:22. [PMID: 39833676 PMCID: PMC11749074 DOI: 10.1186/s12876-025-03618-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2024] [Accepted: 01/15/2025] [Indexed: 01/22/2025] Open
Abstract
BACKGROUND Visceral pain sensitization and emotional reactions due to irritable bowel syndrome (IBS) occur frequently in the general population. Oxidative stress plays a crucial role in the pathogenesis of IBS. Previous studies have demonstrated that activation of peroxisome proliferator-activated receptor gamma (PPARγ) has analgesic effects. Therefore, we aimed to determine whether PPARγ activation ameliorates oxidative stress and affects thus nociceptive sensitization and emotional responses in IBS. METHODS The study utilized male Sprague-Dawley (SD) rats, that suffered from neonatal colorectal distension (CRD), to assess the effects of various doses of rosiglitazone on visceral hyperalgesia and anxiety. Electromyography (EMG) of the external abdominal oblique muscles was used to evaluate visceral hypersensitivity, and Open Field Test (OFT) and Elevated Plus Maze (EPM) were used to evaluate anxiety. Superoxide dismutase (SOD) and malondialdehyde (MDA) in the spinal cord were analyzed by water-soluble tetrazolium-1 (WST-1) and thiobarbituric acid (TBA) methods, respectively, the expression levels of PPARγ in the spinal cord were assessed by qRT-PCR and Western blotting. RESULTS Neonatal CRD-induced rats showed visceral pain sensitization and anxiety in adulthood, with down-regulated expression of PPARγ and SOD and elevated MDA levels in the spinal cord. Rosiglitazone alleviated visceral hypersensitivity and anxiety by activating PPARγ protein expression and promoting MDA up-regulation and SOD down-regulation in the spinal cord, which were reversed by GW9662, an antagonist of PPARγ. CONCLUSION This study demonstrated that rosiglitazone alleviated visceral pain sensitization and anxiety in male IBS rats by alleviating oxidative stress through activation of PPARγ.
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Affiliation(s)
- Minjie Li
- Department of Anesthesiology, First Affiliated Hospital, Fujian Medical University, No. 20, Cha Zhong Road, Fuzhou, Fujian Province, People's Republic of China
- Department of Anesthesiology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Xiyu Zhuo
- Department of Anesthesiology, Fujian Provincial Hospital, Fuzhou, China
| | - Yongxiao Liu
- Department of Anesthesiology, First Affiliated Hospital, Fujian Medical University, No. 20, Cha Zhong Road, Fuzhou, Fujian Province, People's Republic of China
- Department of Anesthesiology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Jinchao You
- Department of Anesthesiology, First Affiliated Hospital, Fujian Medical University, No. 20, Cha Zhong Road, Fuzhou, Fujian Province, People's Republic of China
- Department of Anesthesiology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Jianqing Lin
- Department of Anesthesiology, First Affiliated Hospital, Fujian Medical University, No. 20, Cha Zhong Road, Fuzhou, Fujian Province, People's Republic of China.
- Department of Anesthesiology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China.
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17
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Katzenstein C, Keefer L. Editorial: Food for Thought-Addressing the Nuances of Diet and Mood When Evaluating Dietary Intervention in IBS. Aliment Pharmacol Ther 2025; 61:198-199. [PMID: 39508137 DOI: 10.1111/apt.18372] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2024]
Affiliation(s)
| | - Laurie Keefer
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
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18
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Liu D, Cao M, Wu S, Jiang Y, Cao W, Lin T, Li F, Sha F, Yang Z, Tang J. Modifiable factors for irritable bowel syndrome: evidence from Mendelian randomisation approach. EGASTROENTEROLOGY 2025; 3:e100126. [PMID: 39944930 PMCID: PMC11770431 DOI: 10.1136/egastro-2024-100126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2024] [Accepted: 12/24/2024] [Indexed: 03/23/2025]
Abstract
ABSTRACT Background The potential modifiable factors influencing irritable bowel syndrome (IBS) have not been thoroughly documented. We aimed to systematically investigate the modifiable factors associated with IBS, while accounting for the impact of unobserved confounders and coexisting disorders. Methods Genetic correlation and Mendelian randomisation (MR) analyses were integrated to identify potential modifiable factors and coexisting disorders linked to IBS. Subsequently, multiresponse MR (MR2) was employed to further examine these associations. Summary-level genome-wide association data were used. Modifiable factors and coexisting disorders (ie, gastrointestinal and psychiatric disorders) were identified based on evidence from cohort studies and meta-analysis. In all analyses, IBS was the primary outcome, while in the MR2 analysis, coexisting disorders were also treated as outcomes alongside IBS. Results Most identified modifiable factors and coexisting disorders exhibited genetic correlations with IBS. MR analyses revealed strong causation between IBS and multisite chronic pain (OR=2.20, 95% CI 1.82 to 2.66), gastro-oesophageal reflux disease (OR=1.31, 95% CI 1.23 to 1.39), well-being spectrum (OR=0.17, 95% CI 0.13 to 0.21), life satisfaction (OR=0.31, 95% CI 0.25 to 0.38), positive affect (OR=0.30, 95% CI 0.24 to 0.37), neuroticism score (OR=1.20, 95% CI 1.16 to 1.25) and depression (OR=1.50, 95% CI 1.37 to 1.66). Additionally, smoking, alcohol frequency, college or university degree, intelligence, childhood maltreatment, frailty index, diverticular disease of the intestine and schizophrenia were suggestively associated with IBS. Robust associations were found between multisite chronic pain and both IBS and coexisting disorders. Conclusions Our study identified a comprehensive array of potential modifiable factors and coexisting disorders associated with IBS, supported by genetic evidence, including genetic correlation and multiple MR analyses. The presence of multisite chronic pain may offer a promising avenue for the concurrent prevention of IBS and its coexisting disorders.
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Affiliation(s)
- Di Liu
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Meiling Cao
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Shanshan Wu
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- State Key Laboratory for Digestive Health, Beijing, China
- National Clinical Research Center for Digestive Diseases, Beijing, China
| | - Yiwen Jiang
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Weijie Cao
- Edith Cowan University, Joondalup, Western Australia, Australia
| | - Tengfei Lin
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Fuxiao Li
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
- Department of Computational Biology and Medical Big Data, Shenzhen University of Advanced Technology, Shenzhen, Guangdong, China
| | - Feng Sha
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Zhirong Yang
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
- Department of Computational Biology and Medical Big Data, Shenzhen University of Advanced Technology, Shenzhen, Guangdong, China
| | - Jinling Tang
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
- Department of Computational Biology and Medical Big Data, Shenzhen University of Advanced Technology, Shenzhen, Guangdong, China
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Huang Y, You Y, Wang W, Chen YH, Zhang H, Li QP, Liu L, Tong K, Sun N, Hao JR, Gao C. Adenosine regulates depressive behavior in mice with chronic social defeat stress through gut microbiota. Neuropharmacology 2025; 262:110209. [PMID: 39510376 DOI: 10.1016/j.neuropharm.2024.110209] [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: 08/13/2024] [Revised: 10/28/2024] [Accepted: 11/04/2024] [Indexed: 11/15/2024]
Abstract
Major depressive disorder (MDD) is recognized as the most prevalent affective disorder worldwide. Metagenomic studies increasingly support a critical role for dysbiosis of gut microbiota in the development of depression. Previous studies have demonstrated that adenosine alleviates gut dysbiosis, suggesting that elevating adenosine levels could be a novel intervention for MDD; however, the mechanisms underlying this effect remain unclear. This study utilized 16S rRNA gene sequencing, fecal microbiota transplantation (FMT) and ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) to test the hypothesis that increased adenosine alleviates depressive behaviors in male mice subjected to chronic social defeat stress (CSDS) through alterations to gut microbiota. The data showed that depression-susceptible (SUS) mice exhibited gut dysbiosis, and FMT from SUS mice increased depression-like behaviors in healthy recipients. In SUS mice, adenosine supplementation ameliorated both depression-like behaviors and abnormalities in gut microbiota, and co-administration of probiotics and adenosine not only mitigated depression-like behaviors but also enhanced gut barrier integrity. By including 83 depressed adolescents and 67 healthy controls, this study found that the level of short-chain fatty acids (SCFAs) in the depression group was reduced, this finding parallels reductions seen in SUS mice and in recipient mice after FMT from SUS donors. Conversely, supplementation with either adenosine or probiotics led increased SCFAs concentrations in the serum of SUS mice. These findings suggest that adenosine may alleviate depression-like behaviors in CSDS mice by modulating the gut microbiota. This effect is likely associated with increased serum SCFAs, metabolites produced by the gut microbiota, following adenosine supplementation. This article is part of the Special Issue on "Personality Disorders".
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Affiliation(s)
- Yao Huang
- Jiangsu Province Key Laboratory of Anesthesiology, Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application, NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
| | - Yue You
- Jiangsu Province Key Laboratory of Anesthesiology, Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application, NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
| | - Wei Wang
- School of Public Health, Xuzhou Medical University, Jiangsu, 221004, China
| | - Yuan-Hao Chen
- Jiangsu Province Key Laboratory of Anesthesiology, Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application, NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
| | - Hao Zhang
- Jiangsu Province Key Laboratory of Anesthesiology, Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application, NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
| | - Qu-Peng Li
- Jiangsu Province Key Laboratory of Anesthesiology, Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application, NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
| | - Le Liu
- Jiangsu Province Key Laboratory of Anesthesiology, Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application, NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
| | - Kun Tong
- Jiangsu Province Key Laboratory of Anesthesiology, Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application, NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
| | - Nan Sun
- Jiangsu Province Key Laboratory of Anesthesiology, Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application, NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
| | - Jing-Ru Hao
- Jiangsu Province Key Laboratory of Anesthesiology, Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application, NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
| | - Can Gao
- Jiangsu Province Key Laboratory of Anesthesiology, Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application, NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China; School of Life Sciences, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China.
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20
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Xing J, Li Y, Hu J, Gu L, Sun G, Li X. Lateral periaqueductal gray participate in the regulation of irritable bowel syndrome induced by chronic restraint stress. Neurobiol Dis 2025; 204:106758. [PMID: 39638155 DOI: 10.1016/j.nbd.2024.106758] [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: 10/16/2024] [Revised: 11/29/2024] [Accepted: 11/30/2024] [Indexed: 12/07/2024] Open
Abstract
Irritable bowel syndrome (IBS) is a functional bowel disorder defined by recurrent abdominal pain, coupled with irregular bowel habits and alterations in the frequency as well as the consistency of stool. At present, IBS is considered as a disease of gut-brain interaction, and an increasing number of studies are focusing on the brain-gut axis. However, the brain regions associated with IBS have not been fully studied yet. In this study, we utilized the chronic restraint stress (CRS) model to evoke IBS-like symptoms in mice, which were accompanied by anxiety-like behaviors and hyperalgesia. Through cFOS staining, we observed the activation of the lateral periaqueductal gray (LPAG) in the mice after CRS. By inhibiting the activity of the LPAG through tetanus toxin or chemogenetics, we found that IBS-like symptoms could be relieved, whereas chemogenetic activation of the LPAG induced IBS-like symptoms. Finally, we utilized the classic analgesic drug sufentanil and found that it could alleviate CRS-induced IBS-like symptoms.
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Affiliation(s)
- Jiaotao Xing
- Department of Anorectal, Affiliated Nanhua Hospital, University of south China, Hengyang 421200, Hunan, China
| | - Ying Li
- Department of Anorectal, Affiliated Nanhua Hospital, University of south China, Hengyang 421200, Hunan, China
| | - Jiali Hu
- Central Hospital of Hengyang City, Hengyang 421200, Hunan, China
| | - Liyao Gu
- Central Hospital of Hengyang City, Hengyang 421200, Hunan, China
| | - Guanghua Sun
- The First Affiliated Hospital, Department of Rehabilitation, Hengyang Medical School, University of South China, Hengyang 421200, Hunan, China
| | - Xiangle Li
- Central Hospital of Hengyang City, Hengyang 421200, Hunan, China.
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21
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Zhao Y, Zhu S, Dong Y, Xie T, Chai Z, Gao X, Dai Y, Wang X. The Role of Gut Microbiome in Irritable Bowel Syndrome: Implications for Clinical Therapeutics. Biomolecules 2024; 14:1643. [PMID: 39766350 PMCID: PMC11674646 DOI: 10.3390/biom14121643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2024] [Revised: 12/12/2024] [Accepted: 12/19/2024] [Indexed: 01/11/2025] Open
Abstract
Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder (FGID) characterized by chronic or recurrent gastrointestinal symptoms without organic changes, and it is also a common disorder of gut-brain interaction (DGBIs).. The symptoms of IBS not only affect the quality of life for individual patients but also place a significant burden on global healthcare systems. The lack of established and universally applicable biomarkers for IBS, along with the substantial variability in symptoms and progression, presents challenges in developing effective clinical treatments. In recent years, preclinical and clinical studies have linked the pathogenesis of IBS to alterations in the composition and function of the intestinal microbiota. Within the complex microbial community of the gut, intricate metabolic and spatial interactions occur among its members and between microbes and their hosts. Amid the multifaceted pathophysiology of IBS, the role of intestinal microenvironment factors in symptom development has become more apparent. This review aims to delve into the changes in the composition and structure of the gut microbiome in individuals with IBS. It explores how diet-mediated alterations in intestinal microbes and their byproducts play a role in regulating the pathogenesis of IBS by influencing the "brain-gut" axis, intestinal barrier function, immune responses, and more. By doing so, this review seeks to lay a theoretical foundation for advancing the development of clinical therapeutics for IBS.
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Affiliation(s)
- Yucui Zhao
- Key Laboratory of Pharmacology of Traditional Chinese Medical Formulae, Ministry of Education, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China; (Y.Z.); (S.Z.); (Y.D.); (T.X.); (Z.C.); (X.G.)
- School of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Shixiao Zhu
- Key Laboratory of Pharmacology of Traditional Chinese Medical Formulae, Ministry of Education, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China; (Y.Z.); (S.Z.); (Y.D.); (T.X.); (Z.C.); (X.G.)
- School of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Yingling Dong
- Key Laboratory of Pharmacology of Traditional Chinese Medical Formulae, Ministry of Education, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China; (Y.Z.); (S.Z.); (Y.D.); (T.X.); (Z.C.); (X.G.)
- School of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Tian Xie
- Key Laboratory of Pharmacology of Traditional Chinese Medical Formulae, Ministry of Education, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China; (Y.Z.); (S.Z.); (Y.D.); (T.X.); (Z.C.); (X.G.)
- School of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Zhiqiang Chai
- Key Laboratory of Pharmacology of Traditional Chinese Medical Formulae, Ministry of Education, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China; (Y.Z.); (S.Z.); (Y.D.); (T.X.); (Z.C.); (X.G.)
- School of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Xiumei Gao
- Key Laboratory of Pharmacology of Traditional Chinese Medical Formulae, Ministry of Education, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China; (Y.Z.); (S.Z.); (Y.D.); (T.X.); (Z.C.); (X.G.)
| | - Yongna Dai
- Key Laboratory of Pharmacology of Traditional Chinese Medical Formulae, Ministry of Education, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China; (Y.Z.); (S.Z.); (Y.D.); (T.X.); (Z.C.); (X.G.)
| | - Xiaoying Wang
- Key Laboratory of Pharmacology of Traditional Chinese Medical Formulae, Ministry of Education, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China; (Y.Z.); (S.Z.); (Y.D.); (T.X.); (Z.C.); (X.G.)
- School of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
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22
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Liu P, Zhang Y, Huang H, Li Y. Research on the correlation between inflammatory bowel disease and depression: A bibliometric analysis. Medicine (Baltimore) 2024; 103:e40414. [PMID: 39705423 DOI: 10.1097/md.0000000000040414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2024] Open
Abstract
BACKGROUND The aim of this study was to conduct a bibliometric analysis of published studies on the relationship between inflammatory bowel disease (IBD) and depression. The study also aims to identify the major researchers, institutions, and countries and regions in this field to identify current research hotspots. METHODS The Web of Science Core Database in the Science Citation Index Expanded database was selected as the data source and was searched to obtain relevant literature on IBD and depression. Bibliometric analysis of relevant publications was performed by utilizing VOSviewer, CiteSpace, bibliometrix, and Microsoft Excel 2019. RESULTS A total of 393 papers were included from January 1, 2014, to December 25, 2023, showing a general upward trend in the number of publications. There were 48 countries and 743 institutions, of which the United States had the largest number of publications. There were 2250 authors involved in research in the field, with clear collaborations between authors. There were currently 163 journals that have published research on this topic, with IBDs being the most cited journal. IBD and depression-related studies are gradually gaining attention from researchers, and the research direction is gradually expanding to epidemiology, gut microbiota, and other related topics. CONCLUSION This study comprehensively summarizes the research trends and developments of IBD and depression through bibliometrics. This information points out the research frontiers and hot directions in recent years, which will serve as a reference for researchers in this field.
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Affiliation(s)
- Pengliang Liu
- Henan University of Chinese Medicine, Zhengzhou, China
- Collaborative Innovation Center of Research and Development on the Whole Industry Chain of Yu-Yao, Zhengzhou, Henan Province, China
| | - Yongchuang Zhang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Huang Huang
- Collaborative Innovation Center of Research and Development on the Whole Industry Chain of Yu-Yao, Zhengzhou, Henan Province, China
- Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou, China
| | - Yucheng Li
- Collaborative Innovation Center of Research and Development on the Whole Industry Chain of Yu-Yao, Zhengzhou, Henan Province, China
- Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou, China
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23
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He T, Kang J, Tang X, Wu Y, Hao L. Overexpression of MCL1 attenuates irritable bowel syndrome by regulating cuproptosis: Screening and validation. Biochem Biophys Res Commun 2024; 737:150926. [PMID: 39488085 DOI: 10.1016/j.bbrc.2024.150926] [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: 07/23/2024] [Revised: 09/30/2024] [Accepted: 10/29/2024] [Indexed: 11/04/2024]
Abstract
Irritable bowel syndrome (IBS) is a type of chronic bowel disorder with a poorly understood pathophysiology. Recently, the imbalance of copper has been reported to influence the progression of IBS, suggesting cuproptosis, a new type of copper-induced cell death, may play a role in IBS. This study found 17 cuproptosis-related differentially expressed genes in IBS through bioinformatic analysis. Six hub genes were identified after the protein-protein interaction network analysis, namely myeloid cell leukemia 1 (MCL1), epidermal growth factor receptor 2, cadherin-associated protein beta 1, solute carrier family 25 members 37, solute carrier family 39 members 14, and six transmembrane epithelial antigens of the prostate 3. We selected MCL1 for further verification. Human normal colon epithelial cell line (NCM460) was used to construct models of IBS or cuproptosis in vitro by lipopolysaccharide (LPS) or LPS combined with copper (II) chloride (CuCl2). We observed that overexpression of MCL1 promoted cell viability and proliferation ability, and inhibited the secretion of inflammatory factors and expression of Bax and caspase-3 of NCM460 cells treated with LPS or LPS combined with CuCl2. In addition, up-regulated MCL1 significantly suppressed the protein levels of ferredoxin 1 and lipoyl synthase, two key regulators of cuproptosis. In conclusion, our study demonstrates that cuproptosis is involved in IBS and identifies a cuproptosis-related gene, MCL1, that helps alleviate IBS by promoting cell growth, reducing inflammation, and suppressing cuproptosis, making it a promising therapeutic target in IBS.
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Affiliation(s)
- Taohong He
- Department of Proctology, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39, Shi-er-qiao Road, Jinniu District, Chengdu City, Sichuan Province, 610072, China
| | - Jian Kang
- Department of Proctology, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39, Shi-er-qiao Road, Jinniu District, Chengdu City, Sichuan Province, 610072, China; School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, No.37-39, Shi-er-qiao Road, Jinniu District, Chengdu City, Sichuan Province, 610075, China
| | - Xiao Tang
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, No. 23, Meishuguan Back Street, Dongcheng District, Beijing, 100010, China
| | - Yuqi Wu
- Department of Proctology, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39, Shi-er-qiao Road, Jinniu District, Chengdu City, Sichuan Province, 610072, China; School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, No.37-39, Shi-er-qiao Road, Jinniu District, Chengdu City, Sichuan Province, 610075, China
| | - Liangliang Hao
- Department of Proctology, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39, Shi-er-qiao Road, Jinniu District, Chengdu City, Sichuan Province, 610072, China.
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Haddadin R, Aboujamra D, Merhavy ZI, Trad G, Ryan J, Shetty K. Think With Your Gut: A Retrospective Analysis on the Effects of Chronic Gastrointestinal Illness and Psychiatric Comorbidities. Gastroenterology Res 2024; 17:212-216. [PMID: 39802928 PMCID: PMC11711033 DOI: 10.14740/gr1765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2024] [Accepted: 09/30/2024] [Indexed: 01/16/2025] Open
Abstract
Background As mental health awareness increases, healthcare professionals must understand the interplay between chronic gastrointestinal (GI) conditions and psychological well-being, particularly regarding healthcare utilization. This study uniquely aggregates various chronic GI disorders, such as inflammatory bowel disease, celiac disease, and eosinophilic esophagitis, to examine their impact on depression and anxiety. Methods Utilizing a retrospective observational design, we analyzed data from 34,876 patients admitted to HCA national hospitals from January 2016 to December 2022. Results We found that patients with GI conditions and comorbid psychiatric disorders had significantly higher readmission rates and longer hospital stays compared to those without mental health diagnoses. Results indicated that patients with GI disorders and depression or anxiety were 1.29 times more likely to be readmitted within 90 days and had 1.50 times longer hospital stay. Conclusion These findings underscore the importance of integrated care approaches addressing physical and mental health in managing chronic GI conditions. Future research should focus on targeted interventions to enhance mental health management and improve outcomes in this vulnerable patient population.
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Affiliation(s)
- Rakahn Haddadin
- Department of Internal Medicine, HCA Healthcare; MountainView Hospital, Las Vegas, NV, USA
| | - Danny Aboujamra
- Department of Internal Medicine, Medical University of South Carolina (MUSC) Health Florence, SC, USA, Florence, SC 29505, USA
| | - Zachary I. Merhavy
- Department of Clinical Sciences, Ross University School of Medicine, Pontiac, MI 48341, USA
| | - George Trad
- Department of Gastroenterology, HCA Healthcare; Southern Hills Hospital, Las Vegas, NV 89128, USA
| | - John Ryan
- Department of Gastroenterology, HCA Healthcare; Southern Hills Hospital, Las Vegas, NV 89128, USA
| | - Kartika Shetty
- Department of Internal Medicine, HCA Healthcare; MountainView Hospital, Las Vegas, NV, USA
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Coitinho Biurra Y, Naude C, Marchese SH, Evans S, Barber E, Parigi E, Cheah S, Palsson O, Sperber AD, Tack J, Drossman D, Mikocka-Walus A, Taft T. Symptom bothersomeness and life interference support Rome clinical criteria as clinically relevant indicators of DGBI. Neurogastroenterol Motil 2024; 36:e14936. [PMID: 39370619 DOI: 10.1111/nmo.14936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Revised: 09/02/2024] [Accepted: 09/24/2024] [Indexed: 10/08/2024]
Abstract
BACKGROUND Irritable bowel syndrome (IBS) and functional dyspepsia (FD) are common disorders of gut-brain interaction (DGBI). The Rome IV criteria are the gold standard for research when diagnosing DGBI. However, bothersomeness, or the degree to which symptoms are distressing or disruptive to a person's daily life, is a potential treatment-seeking motivator that is not assessed by the Rome criteria. The Rome Foundation developed and published diagnostic criteria for clinical practice that include bothersomeness. We aimed to evaluate these constructs via patient focus groups to determine what prompts healthcare-seeking as a means to assess its value in the Rome clinical criteria. METHODS Adults meeting Rome IV criteria for IBS, FD, or both participated in focus groups in Australia and the United States. Semi-structured interview transcripts were analyzed using Template Thematic Analysis, with three a priori and other a posteriori themes refined iteratively through team discussion and consensus. KEY RESULTS Participants confirmed the frequency and duration of symptoms was not sufficient to reflect illness experience. Four major themes emerged: (1) Bothersomeness should be included in assessments of IBS and FD; (2) Patients find many DGBI symptoms bothersome; (3) Bothersomeness traverses multiple domains of quality of life; (4) Patients may hesitate to seek medical advice due to past negative experiences. CONCLUSIONS AND INFERENCES These findings support the value of the Rome Clinical Criteria. They emphasize the importance of expanding assessments of patients with DGBI to include how bothersome they perceive symptoms to be, how much symptoms interfere with their daily life, and what may moderate their decisions to seek treatment.
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Affiliation(s)
| | - Colette Naude
- School of Psychology, Deakin University, Melbourne, Victoria, Australia
| | - Sara H Marchese
- Division of Gastroenterology and Hepatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Subhadra Evans
- School of Psychology, SEED-Lifespan Strategic Research Centre, Faculty of Health, Deakin University, Melbourne, Victoria, Australia
| | - Emily Barber
- School of Psychology, Deakin University, Melbourne, Victoria, Australia
| | - Elesha Parigi
- School of Psychology, Deakin University, Melbourne, Victoria, Australia
| | - Suiyin Cheah
- School of Psychology, Deakin University, Melbourne, Victoria, Australia
| | - Olafur Palsson
- Center for Functional GI and Motility Disorders, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
- The Rome Foundation Research Institute, Chapel Hill, North Carolina, USA
| | - Ami D Sperber
- The Rome Foundation Research Institute, Chapel Hill, North Carolina, USA
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Jan Tack
- The Rome Foundation Research Institute, Chapel Hill, North Carolina, USA
- Department of Clinical and Experimental Medicine, University of Leuven, Leuven, Belgium
| | - Douglas Drossman
- Center for Functional GI and Motility Disorders, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
- The Rome Foundation Research Institute, Chapel Hill, North Carolina, USA
- Center for Education and Practice of Biopsychosocial Care, and Drossman Gastroenterology, Chapel Hill, North Carolina, USA
| | - Antonina Mikocka-Walus
- School of Psychology, SEED-Lifespan Strategic Research Centre, Faculty of Health, Deakin University, Melbourne, Victoria, Australia
| | - Tiffany Taft
- Division of Gastroenterology and Hepatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- The Rome Foundation Research Institute, Chapel Hill, North Carolina, USA
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Ballou S, Vasant DH, Guadagnoli L, Reed B, Chiarioni G, ten Cate L, Keefer L, Kinsinger SW. A primer for the gastroenterology provider on psychosocial assessment of patients with disorders of gut-brain interaction. Neurogastroenterol Motil 2024; 36:e14894. [PMID: 39135459 PMCID: PMC11563843 DOI: 10.1111/nmo.14894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 07/09/2024] [Accepted: 07/31/2024] [Indexed: 08/21/2024]
Abstract
BACKGROUND GI-specific psychological factors are important contributors to patients' symptom experience and quality of life across all disorders of gut-brain interaction (DGBI). Clinicians' ability to recognize the role of these psychological factors is essential for formulating a biopsychosocial case conceptualization and informing treatment decisions. PURPOSE This article will familiarize gastroenterology providers with conceptualizing the role of GI-specific psychological factors in DGBI and provides stepwise, practical guidance for how to assess these during clinical encounters in a time-efficient manner.
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Affiliation(s)
- Sarah Ballou
- Division of Gastroenterology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Dipesh H. Vasant
- Neurogastroenterology Unit, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Manchester, UK
| | - Livia Guadagnoli
- Laboratory for Brain-Gut Axis Studies (LaBGAS), Translational Research Center for Gastrointestinal Disorders (TARGID), KU Leuven, Leuven, Belgium
| | - Bonney Reed
- Department of Pediatrics, Emory University School of Medicine and Children’s Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Giuseppe Chiarioni
- II Cerchio Med Global Healthcare, Verona, Italy
- UNC Center for Functional GI and Motility Disorders, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Liesbeth ten Cate
- Stem en Spraak (Voice and Speech), Logopedie aan de Amstel, Private Practice, Amsterdam, The Netherlands
| | - Laurie Keefer
- The Henry D. Janowitz Division of Gastroenterology, The Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Sarah W. Kinsinger
- Division of Gastroenterology, Department of Medicine, Loyola University Medical Center, Maywood, Illinois, USA
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27
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Lynch E, Mulligan S, Doyle SL. An exploration of fibre intake and bowel function in a sample of adults at an Irish university campus. Ir J Med Sci 2024; 193:2753-2760. [PMID: 39088161 PMCID: PMC11666678 DOI: 10.1007/s11845-024-03764-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 07/22/2024] [Indexed: 08/02/2024]
Abstract
BACKGROUND Bowel dysfunction can significantly impair quality of life. Adequate fibre intake is associated with good bowel health but intakes have been reported to be low in Ireland. AIM This study aimed to gather data on fibre intake and bowel habits in a cohort of adults at a university campus in Dublin, Ireland. METHODS An online questionnaire was developed by adapting validated tools to assess habitual fibre intake and bowel function. The questionnaire was circulated through mailing lists and advertised via QR codes on campus in February/March 2023. Data was analysed using SPSS, p < 0.05 was considered statistically significant. RESULTS In total, 275 valid responses were received. Low fibre intakes (< 19 g/day) were found in 50.5% of participants. A significantly higher proportion of males had low fibre intake compared to females (62.2% vs 44.8%, p = 0.039). Nearly a third (30.2%) of respondents experienced mild symptoms of bowel dysfunction, and 13.1% experienced moderate to severe symptoms. An inverse relationship was observed between fibre intake (g/day) and bowel dysfunction (p = 0.033). CONCLUSIONS In this cohort, low fibre intakes and some degree of bowel dysfunction were prevalent. Public health campaigns to increase fibre intake could prove to be a cost-effective way to improve bowel function and health amongst adults in Ireland.
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Affiliation(s)
- Ellen Lynch
- School of Biological, Health and Sports Sciences, Technological University Dublin, Grangegorman, Dublin 7, Dublin, D07 XT95, Ireland
| | - Sophie Mulligan
- School of Biological, Health and Sports Sciences, Technological University Dublin, Grangegorman, Dublin 7, Dublin, D07 XT95, Ireland
| | - Suzanne L Doyle
- School of Biological, Health and Sports Sciences, Technological University Dublin, Grangegorman, Dublin 7, Dublin, D07 XT95, Ireland.
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Black CJ, Ford AC. Personalisation of therapy in irritable bowel syndrome: a hypothesis. Lancet Gastroenterol Hepatol 2024; 9:1162-1176. [PMID: 39521004 DOI: 10.1016/s2468-1253(24)00245-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 07/18/2024] [Accepted: 07/23/2024] [Indexed: 11/16/2024]
Abstract
Irritable bowel syndrome (IBS) is a common disorder of gut-brain interaction characterised by symptoms of abdominal pain, occurring at least 1 day per week, and a change in stool frequency or form. Individuals with IBS are usually subtyped according to their predominant bowel habit, which is used to direct symptom-based treatment. However, this approach is probably an oversimplification of a complex and multidimensional condition, and other factors, such as psychological health, are known to influence symptom severity and prognosis. We have previously used latent class analysis, a method of mathematical modelling, to show that people with IBS can be classified into seven unique clusters based on a combination of gastrointestinal symptoms, abdominal pain, extraintestinal symptoms, and psychological comorbidity. The clusters can be used to predict the prognosis of IBS (eg, symptom severity), health-care use (eg, consultation behaviour, prescribing, and costs), and impact (eg, quality of life, work and productivity, activities of daily living, and income). These clusters could also be used to increase the personalisation of IBS treatment that better recognises the heterogenous nature of the condition. We present new data providing additional validation of our seven-cluster model and conduct a comprehensive evidence-based review of IBS management. Based on this evidence, we propose a framework of first-line and second-line treatments according to IBS cluster. Finally, we discuss what further research is needed to implement this approach in clinical practice, including the need for randomised trials comparing cluster-based treatment with conventional treatment according to stool subtype.
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Affiliation(s)
- Christopher J Black
- Leeds Gastroenterology Institute, St James's University Hospital, Leeds, UK; Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK.
| | - Alexander C Ford
- Leeds Gastroenterology Institute, St James's University Hospital, Leeds, UK; Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
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Zhang M, Wu X, Gao H, Zhang L, Li Y, Li M, Zhao C, Wei P, Ou L. Chinese Herbal Medicine for Irritable Bowel Syndrome: A Perspective of Local Immune Actions. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2024; 52:2079-2106. [PMID: 39663262 DOI: 10.1142/s0192415x24500800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2024]
Abstract
Irritable bowel syndrome (IBS) is the functional gastrointestinal disorder, characterized by abdominal pain and altered bowel habits. The interest in intestinal immune activation as a potential disease mechanism for IBS has increased exponentially in recent years. This study was designed to summarize the Chinese herbal medicine (CHM) that potentially exert protective effects against IBS through inhibition of intestinal immune activation. We detailed the current evidence that immune activation contributes to the pathology of IBS and discussed the potential mechanisms involved. Then, therapeutic effects and possible mechanisms related to immune response of herbal medicine prescriptions, extracts, and monomers were analyzed. The reasons leading to the aberrant and persistent immune activation noted in IBS are mainly associated with the increased number of mast cells, CD3[Formula: see text] T cells, and CD4[Formula: see text] T cells. The mechanisms mainly focused on the gut microbiota disorder induced alteration of the PGE2/COX2/SERT/5-HT, TLR4/MyD88/NF-κB, and BDNF/TrkB pathways. Most of the CHM alleviated IBS through interventions of intestinal immune activation via gut microbiota related to the TLR4/MyD88/NF-κB and SCF/c-kit pathways. We hope this review will provide some clues for the further development of novel candidate agents for IBS and other intestinal immune disorders.
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Affiliation(s)
- Mengmeng Zhang
- College of Pharmacy, Shaanxi University of Chinese Medicine, Xianyang 712046, P. R. China
| | - Xu Wu
- College of Pharmacy, Shaanxi University of Chinese Medicine, Xianyang 712046, P. R. China
- Engineering Technology Research Center of Shaanxi, Administration of Chinese Herbal Pieces, Shaanxi University of Chinese Medicine, Xianyang 712046, P. R. China
| | - Huanqing Gao
- College of Pharmacy, Shaanxi University of Chinese Medicine, Xianyang 712046, P. R. China
| | - Lin Zhang
- College of Pharmacy, Shaanxi University of Chinese Medicine, Xianyang 712046, P. R. China
| | - Yao Li
- College of Pharmacy, Shaanxi University of Chinese Medicine, Xianyang 712046, P. R. China
| | - Min Li
- College of Pharmacy, Shaanxi University of Chinese Medicine, Xianyang 712046, P. R. China
| | - Chongbo Zhao
- College of Pharmacy, Shaanxi University of Chinese Medicine, Xianyang 712046, P. R. China
- Engineering Technology Research Center of Shaanxi, Administration of Chinese Herbal Pieces, Shaanxi University of Chinese Medicine, Xianyang 712046, P. R. China
| | - Peifeng Wei
- College of Pharmacy, Shaanxi University of Chinese Medicine, Xianyang 712046, P. R. China
| | - Li Ou
- College of Pharmacy, Shaanxi University of Chinese Medicine, Xianyang 712046, P. R. China
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Nagamine T. The Role of the Gut Microbiota in Individuals with Irritable Bowel Syndrome: A Scoping Review. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1895. [PMID: 39597080 PMCID: PMC11596400 DOI: 10.3390/medicina60111895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2024] [Revised: 11/14/2024] [Accepted: 11/18/2024] [Indexed: 11/29/2024]
Abstract
Irritable bowel syndrome (IBS) represents the most prevalent disorder of brain-gut interaction, affecting approximately 10% of the global population. The objective of this study was to examine the mechanisms by which the gut microbiota contributes to the development of IBS. To this end, a review of articles that examined the gut microbiota of IBS patients was conducted. A search was conducted using PubMed and J-STAGE for articles published over the past five years that relate to the gut microbiota in patients with IBS. Individuals diagnosed with IBS display a reduction in alpha diversity and a decline in butyrate-producing bacteria, which collectively indicate a state of dysbiosis within their gut microbiota. Butyrate plays a dual role in the body, acting as a source of nutrition for the intestinal epithelium while also regulating the expression of dopamine transporters and D2 receptors in the central nervous system through epigenetic mechanisms. These characteristics may be linked to dysfunction of the central dopamine D2 pathway and play a role in the formation of various symptoms in IBS.
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Affiliation(s)
- Takahiko Nagamine
- Department of Psychiatric Internal Medicine, Sunlight Brain Research Center, Hofu 7470066, Japan; ; Fax: +81-835-25-6610
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, Bunkyou 1138510, Japan
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31
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Aggeletopoulou I, Triantos C. Microbiome Shifts and Their Impact on Gut Physiology in Irritable Bowel Syndrome. Int J Mol Sci 2024; 25:12395. [PMID: 39596460 PMCID: PMC11594715 DOI: 10.3390/ijms252212395] [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: 11/01/2024] [Revised: 11/17/2024] [Accepted: 11/18/2024] [Indexed: 11/28/2024] Open
Abstract
Irritable bowel syndrome (IBS) is one of the most prevalent functional gastrointestinal disorders characterized by recurrent abdominal pain and altered bowel habits. The exact pathophysiological mechanisms for IBS development are not completely understood. Several factors, including genetic predisposition, environmental and psychological influences, low-grade inflammation, alterations in gastrointestinal motility, and dietary habits, have been implicated in the pathophysiology of the disorder. Additionally, emerging evidence highlights the role of gut microbiota in the pathophysiology of IBS. This review aims to thoroughly investigate how alterations in the gut microbiota impact physiological functions such as the brain-gut axis, immune system activation, mucosal inflammation, gut permeability, and intestinal motility. Our research focuses on the dynamic "microbiome shifts", emphasizing the enrichment or depletion of specific bacterial taxa in IBS and their profound impact on disease progression and pathology. The data indicated that specific bacterial populations are implicated in IBS, including reductions in beneficial species such as Lactobacillus and Bifidobacterium, along with increases in potentially harmful bacteria like Firmicutes and Proteobacteria. Emphasis is placed on the imperative need for further research to delineate the role of specific microbiome alterations and their potential as therapeutic targets, providing new insights into personalized treatments for IBS.
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Affiliation(s)
| | - Christos Triantos
- Division of Gastroenterology, Department of Internal Medicine, University Hospital of Patras, 26504 Patras, Greece;
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32
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Wang Z, Hou Y, Sun H, Wang Z, Zhang H. Efficacy of acupuncture treatment for diarrhea-predominant irritable bowel syndrome with comorbid anxiety and depression: A meta-analysis and systematic review. Medicine (Baltimore) 2024; 103:e40207. [PMID: 39560589 PMCID: PMC11576010 DOI: 10.1097/md.0000000000040207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 10/04/2024] [Indexed: 11/20/2024] Open
Abstract
BACKGROUND Presently, a diverse range of Western medical interventions are accessible for the management of irritable bowel syndrome with diarrhea (IBS-D) concomitant with comorbid anxiety and depression. However, the concomitant adverse effects have also surfaced, exerting strain on healthcare resources and the socio-economic structure. In recent times, the benefits of acupuncture in the management of IBS-D with coexisting anxiety and depression have become progressively evident. Nevertheless, a paucity of evidence-based medicine exists to substantiate the utilization of acupuncture for the treatment of IBS-D with anxiety and depression. The objective of this study is to examine the effectiveness of acupuncture as an intervention for IBS-D with comorbid anxiety and depression. METHODS We searched 7 databases, including the Chinese Journal Full-text Database, Wanfang Academic Journals Full-text Database, VIP Chinese Scientific Journals Full-text Database, China Biomedical Literature Database, PubMed, Embase, and Cochrane Library, for randomized controlled trials (RCTs) related to acupuncture treatment for IBS with anxiety and depression, published from database inception to August 1, 2023. RevMan 5.4 and Stata 17.0 software were used for meta-analysis of relevant outcome measures. RESULTS This study included a total of 16 RCTs, involving 1305 IBS-D patients (691 in the experimental group and 614 in the control group). The meta-analysis results showed that compared to oral medication, acupuncture therapy improved HAMD scores (MD = 0.88, 95% CI = [0.68, 1.07], P < .00001), HAMA scores (MD = 2.32, 95% CI = [1.70, 2.93], P < .00001), self-rating anxiety scale scores (MD = 11.67, 95% CI = [10.85, 12.49], P < .00001), SDS scores (MD = 9.84, 95% CI = [8.52, 11.16], P < .00001), IBS-SSS scores (MD = 37.48, 95% CI = [12.17, 62.78], P = .004), overall response rate (MD = 1.27, 95% CI = [1.20, 1.35], P < .00001), and relapse rate (MD = 0.27, 95% CI = [0.16, 0.47], P < .00001) in patients with IBS-D comorbid with anxiety and depression. CONCLUSION Acupuncture treatment has a definite and beneficial effect on IBS-D patients with comorbid anxiety and depression.
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Affiliation(s)
- Zhen Wang
- Research Institute of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yi Hou
- School of Acupuncture and Massage, Shandong University of traditional Chinese Medicine, Jinan, Shandong, China
| | - Hongwei Sun
- Research Institute of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Zhengwen Wang
- Research Institute of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Haiyan Zhang
- Research Institute of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine, Jinan, China
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Wu J, Zhang B, Liu X, Gu W, Xu F, Wang J, Liu Q, Wang R, Hu Y, Liu J, Ji X, Lv H, Li X, Peng L, Li X, Zhang Y, Wang S. An Intelligent Intestine-on-a-Chip for Rapid Screening of Probiotics with Relief-Enteritis Function. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2024; 36:e2408485. [PMID: 39344562 DOI: 10.1002/adma.202408485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Revised: 09/11/2024] [Indexed: 10/01/2024]
Abstract
Screening probiotics with specific functions is essential for advancing probiotic research. Current screening methods primarily use animal studies or clinical trials, which are inefficient and costly in terms of time, money, and labor. An intelligent intestine-on-a-chip integrating machine learning (ML) is developed to screen relief-enteritis functional probiotics. A high-throughput microfluidic chip combined with environment control systems provides a standardized and scalable intestinal microenvironment for multiple probiotic cocultures. An unsupervised ML-based score analyzer is constructed to accurately, comprehensively, and efficiently evaluate interactions between 12 Bifidobacterium strains and host cells of the colitis model in the intestine-on-a-chips. The most effective contender, Bifidobacterium longum 3-14, is discovered to relieve intestinal inflammation and enhance epithelial barrier function in vitro and in vivo. A distinct advantage of this strategy is that it can intelligently differentiate small therapeutic variations in probiotic strains and prioritize their efficacies, allowing for economical, efficient, accurate functional probiotics screening.
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Affiliation(s)
- Jing Wu
- School of Medicine, Nankai University, Tianjin, 300071, China
| | - Bowei Zhang
- School of Medicine, Nankai University, Tianjin, 300071, China
| | - Xiaoxia Liu
- School of Medicine, Nankai University, Tianjin, 300071, China
| | - Wentao Gu
- School of Medicine, Nankai University, Tianjin, 300071, China
| | - Fupei Xu
- School of Medicine, Nankai University, Tianjin, 300071, China
| | - Jin Wang
- School of Medicine, Nankai University, Tianjin, 300071, China
| | - Qisijing Liu
- School of Medicine, Nankai University, Tianjin, 300071, China
| | - Ruican Wang
- School of Medicine, Nankai University, Tianjin, 300071, China
| | - Yaozhong Hu
- School of Medicine, Nankai University, Tianjin, 300071, China
| | - Jingmin Liu
- School of Medicine, Nankai University, Tianjin, 300071, China
| | - Xuemeng Ji
- School of Medicine, Nankai University, Tianjin, 300071, China
| | - Huan Lv
- School of Medicine, Nankai University, Tianjin, 300071, China
| | - Xinyang Li
- School of Medicine, Nankai University, Tianjin, 300071, China
| | - Lijun Peng
- School of Medicine, Nankai University, Tianjin, 300071, China
| | - Xiang Li
- School of Medicine, Nankai University, Tianjin, 300071, China
| | - Yan Zhang
- School of Medicine, Nankai University, Tianjin, 300071, China
| | - Shuo Wang
- School of Medicine, Nankai University, Tianjin, 300071, China
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Hsu C, Zeng JH, Chen L, Chen LJ, Li XW, Yang JZ, Liu Y, Liu JL, Li JH, Li JH, Xie XL, Wang Q. 2-Ethylhexyl diphenyl phosphate aggravates colitis-induced neuroinflammation and behavioral abnormalities by inhibiting the PI3K-AKT-NF-κB and Wnt/GSK3β signaling pathways. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 286:117173. [PMID: 39405964 DOI: 10.1016/j.ecoenv.2024.117173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 09/30/2024] [Accepted: 10/08/2024] [Indexed: 11/08/2024]
Abstract
2-Ethylhexyl diphenyl phosphate (EHDPHP), a widely used organophosphorus flame retardant (OPFR), is ubiquitous in daily life because of its extensive application in plastic production. EHDPHPs, which are only superficially applied and not chemically bonded to products, are released into the environment, posing potential health risks. With increasing environmental concentrations, EHDPHP is a growing threat, particularly to individuals with preexisting health conditions who are more susceptible to environmental pollutants. This study examined the effects of EHDPHP exposure in a colitis model, reflecting a rising chronic health issue, by assessing changes in neuroinflammation and neurobehavioral abnormalities. Healthy and dextran sulfate sodium (DSS)-induced colitis C57BL/6 J mice were treated with either 0.2 % Tween or EHDPHP solution (10 mg/kg body weight/day) for 28 days. The study revealed significant increases in the serum and expression levels of TNFα and IL-1β, accompanied by depressive and anxiety-like behaviors. Coexposure to EHDPHP and DSS exacerbated these neurobehavioral impairments. RNA sequencing confirmed that EHDPHP triggered inflammation via the PI3K-Akt-NF-κB and Wnt/GSK3β signaling pathways, as confirmed by Western blot analysis. These findings suggest that EHDPHP aggravates colitis-induced neuroinflammation and neurobehavioral abnormalities, highlighting the harmful impact of EHDPHP, particularly in individuals with preexisting inflammatory conditions.
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Affiliation(s)
- Clare Hsu
- Guangzhou Key Laboratory of Forensic Multi-Omics for Precision Identification, School of Forensic Medicine, Southern Medical University, Guangzhou, Guangdong 510515, China
| | - Jia-Hao Zeng
- Guangzhou Key Laboratory of Forensic Multi-Omics for Precision Identification, School of Forensic Medicine, Southern Medical University, Guangzhou, Guangdong 510515, China
| | - Long Chen
- Guangzhou Key Laboratory of Forensic Multi-Omics for Precision Identification, School of Forensic Medicine, Southern Medical University, Guangzhou, Guangdong 510515, China
| | - Li-Jian Chen
- Guangzhou Key Laboratory of Forensic Multi-Omics for Precision Identification, School of Forensic Medicine, Southern Medical University, Guangzhou, Guangdong 510515, China
| | - Xiu-Wen Li
- Guangzhou Key Laboratory of Forensic Multi-Omics for Precision Identification, School of Forensic Medicine, Southern Medical University, Guangzhou, Guangdong 510515, China
| | - Jian-Zheng Yang
- Guangzhou Key Laboratory of Forensic Multi-Omics for Precision Identification, School of Forensic Medicine, Southern Medical University, Guangzhou, Guangdong 510515, China
| | - Yi Liu
- Guangzhou Key Laboratory of Forensic Multi-Omics for Precision Identification, School of Forensic Medicine, Southern Medical University, Guangzhou, Guangdong 510515, China
| | - Jia-Li Liu
- Guangzhou Key Laboratory of Forensic Multi-Omics for Precision Identification, School of Forensic Medicine, Southern Medical University, Guangzhou, Guangdong 510515, China
| | - Jia-Hao Li
- Guangzhou Key Laboratory of Forensic Multi-Omics for Precision Identification, School of Forensic Medicine, Southern Medical University, Guangzhou, Guangdong 510515, China
| | - Ji-Hui Li
- Guangzhou Key Laboratory of Forensic Multi-Omics for Precision Identification, School of Forensic Medicine, Southern Medical University, Guangzhou, Guangdong 510515, China
| | - Xiao-Li Xie
- Department of Toxicology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, Guangdong 510515, China.
| | - Qi Wang
- Guangzhou Key Laboratory of Forensic Multi-Omics for Precision Identification, School of Forensic Medicine, Southern Medical University, Guangzhou, Guangdong 510515, China.
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Lee JW, Kim N. [Efficacy of Fecal Microbial Transplantation for Improving Symptoms of Irritable Bowel Syndrome - A Pilot Study for Voluntary Participants in Korea]. THE KOREAN JOURNAL OF GASTROENTEROLOGY = TAEHAN SOHWAGI HAKHOE CHI 2024; 84:168-176. [PMID: 39449261 DOI: 10.4166/kjg.2024.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2024] [Revised: 10/14/2024] [Accepted: 10/14/2024] [Indexed: 10/26/2024]
Abstract
Background/Aims Irritable bowel syndrome (IBS) is a chronic, intractable functional disease. It is inferred that fecal microbiota transplantation (FMT) may have favorable efficacy on IBS by gut microbial modification. The aim of this study was to investigate the efficacy of FMT for improving severity in patients with IBS. Methods Patients who voluntarily wanted FMT were consecutively enrolled. The study subjects were classified by subtype of IBS by the ROME IV criteria. The IBS-symptom severity score (IBS-SSS) was used to evaluate the efficacy of FMT. The subjects completed a questionnaire at baseline week 0 and weeks 4, 12, and 24 after FMT. FMT was performed by esophagogastroduodenoscopy using frozen stock stool solution. If the follow-up IBS-SSS achieved less than 75 points, it was defined as remission. Adverse events were also gathered. Results Twenty-one subjects were included from October 2023 until July 2024. There were 7 patients with IBS-C, 10 patients with IBS-D, 2 patients with IBS-M, and 2 patients with IBS-U type. The mean SSS of the IBS-D group was 244.0±64.2, which was higher than IBS-C group (192.9±85.4). Alleviations in IBS-SSS after FMT were observed in 19 subjects (19/21, 90.5%) at week 4. At week 12, 71.4% (5/7) in the IBS-C group and 20.0% (2/10) in the IBS-D group achieved remission. The remission states were maintained up to week 24 and no serious adverse events were reported. Conclusions FMT might be an effective treatment option for improving symptoms of mild to moderate IBS, especially IBS-C.
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Affiliation(s)
- Jung Won Lee
- Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Nayoung Kim
- Department of Internal Medicine and Research Center for Sex-Gender-Specific Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
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Khan A, Menon R, Corning B, Cohn S, Kumfa C, Raji M. Mirtazapine for gastrointestinal and neuropsychological symptoms in older adults with irritable bowel syndrome. Therap Adv Gastroenterol 2024; 18:17562848241278125. [PMID: 39493642 PMCID: PMC11526313 DOI: 10.1177/17562848241278125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 08/08/2024] [Indexed: 11/05/2024] Open
Abstract
Irritable bowel syndrome (IBS) is a common and potentially modifiable contributor to excess disability, morbidity, and poor quality of life. Clinical trials of medications for IBS have largely been in younger adults. Yet, a growing number of adults aged 65 and older are living with IBS. No data exist to guide clinicians in the safe and effective use of medications (e.g., anticholinergics, anti-spasmodics, and tricyclic antidepressants (TCA)) for IBS in the geriatric population. These medications-especially anticholinergics and TCAs-carry a high risk of adverse effects (ADE) in older adults because of age-associated decline in drug metabolism and the high prevalence of multiple chronic conditions. Five or more medications (polypharmacy) are frequently used to treat common psychiatric and medical comorbidities of IBS: anxiety, depression, insomnia, migraine headache, diarrhea, nausea, poor appetite, pruritus/skin atopy, and fibromyalgia. These neurological and psychiatric comorbidities reflect shared pathogenic mechanisms and bidirectional crosstalk of high inflammation, alteration of gut microbiota, and dysregulation of multiple gastrointestinal and central nervous system-active neurotransmitters (e.g., serotonin, neuropeptides). Currently, these IBS-associated conditions are treated with multiple medications-which increase the risk of adverse drug-drug interactions. One way to reduce the number of medications used for IBS-associated conditions is the use of one medication that treats many or all of these conditions-Mirtazapine. In this perspective article, we present evidence from basic science, case series, observational and epidemiological studies, clinical studies, and clinical trials supporting mirtazapine, a noradrenergic and specific serotonergic receptor antagonist-with 5-hydroxytryptamine-2 and 3 antagonism, as a potential pharmacotherapeutic intervention for the myriad symptoms and conditions associated with IBS. Specifically, we found evidence of mirtazapine's role in treating diarrhea, insomnia, migraine headache, nausea, and poor appetite. We propose a large randomized controlled trial to study mirtazapine as a potential one-stop treatment for multiple IBS symptoms, with the potential to reduce polypharmacy and ADEs, especially in the geriatric population.
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Affiliation(s)
- Ayesha Khan
- Department of Internal Medicine, University of Texas at Medical Branch, 301 University Blvd, 5.138 RS, Galveston, TX 77555-5302, USA
| | - Raakhi Menon
- Department of Internal Medicine, University of Texas at Medical Branch, Galveston, TX, USA
| | - Brooke Corning
- Department of Gastroenterology and Hepatology, University of Texas at Medical Branch, Galveston, TX, USA
| | - Steven Cohn
- Department of Gastroenterology and Hepatology, University of Texas at Medical Branch, Galveston, TX, USA
| | - Cecil Kumfa
- Division of Geriatrics and Palliative Medicine, University of Texas at Medical Branch, Galveston, TX, USA
| | - Mukaila Raji
- Division of Geriatrics and Palliative Medicine, University of Texas at Medical Branch, Galveston, TX, USA
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Ribichini E, Scalese G, Mocci C, Severi C. Gut-Brain Axis and Psychopathology: Exploring the Impact of Diet with a Focus on the Low-FODMAP Approach. Nutrients 2024; 16:3515. [PMID: 39458509 PMCID: PMC11510627 DOI: 10.3390/nu16203515] [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: 10/05/2024] [Revised: 10/14/2024] [Accepted: 10/16/2024] [Indexed: 10/28/2024] Open
Abstract
BACKGROUND The gut-brain axis (GBA) is a bidirectional communication network connecting the central nervous system with the gastrointestinal (GI) tract, influencing both mental and physical health. Recent research has underscored the significant role of diet in modulating this axis, with attention to how specific dietary patterns can impact anxiety and depression, particularly when linked to disorders of gut-brain interaction (DGBIs), like intestinal bowel syndrome (IBS). AIMS AND METHODS This narrative review examines the effects of specific diet regimens on the GBA and its potential role in managing psychopathology, focusing on anxiety and depression, IBS, and the low-FODMAP diet. We conducted a search on PubMed and MEDLINE by combining the following key terms: "Gut-Brain Axis", "Irritable Bowel Syndrome", "Low FODMAP diet", "Mediterranean Diet", "Psychopathology", "Anxiety and Depression", and "Gut Microbiota". We applied the following filters: "Clinical Trials", "Randomized Controlled Trials", "Reviews", "Meta-Analyses", and "Systematic Reviews". In total, 59 papers were included. RESULTS Low-FODMAP diet, originally developed to alleviate GI symptoms in IBS, may also positively influence mental health by modulating the GBA and improving the gut microbiota (GM) composition. New insights suggest that combining the low-FODMAP diet with the Mediterranean diet could offer a synergistic effect, enhancing both GI and psychological therapeutic outcomes. CONCLUSIONS Understanding the complex interactions between diet, the GM, and mental health opens new avenues for holistic approaches to managing psychopathology, particularly when linked to GI symptoms.
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Affiliation(s)
- Emanuela Ribichini
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00161 Rome, Italy; (G.S.); (C.M.); (C.S.)
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Cheng X, Ren C, Mei X, Jiang Y, Zhou Y. Gut microbiota and irritable bowel syndrome: status and prospect. Front Med (Lausanne) 2024; 11:1429133. [PMID: 39484201 PMCID: PMC11524842 DOI: 10.3389/fmed.2024.1429133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 10/07/2024] [Indexed: 11/03/2024] Open
Abstract
Irritable bowel syndrome (IBS) is a very common gastrointestinal disease that, although not as aggressive as tumors, affects patients' quality of life in different ways. The cause of IBS is still unclear, but more and more studies have shown that the characteristics of the gut microbiota, such as diversity, abundance, and composition, are altered in patients with IBS, compared to the healthy population, which confirms that the gut microbiota plays a crucial role in the development of IBS. This paper aims to identify the commonalities by reviewing a large body of literature. Changes in the characteristics of gut microbiota in patients with different types of IBS are discussed, relevant mechanisms are described, and the treatment modalities of gut microbiota in IBS are summarized. Although there are more clinical trials that have made good progress, more standardized, more generalized, larger-scale, multi-omics clinical studies are what is missing. Overall, gut microbiota plays a crucial role in the development of IBS, and there is even more potential for treating IBS by modulating gut microbiota.
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Affiliation(s)
- Xinyu Cheng
- Department of Cardiology, The Fourth Affiliated Hospital of Soochow University, Medical Center of Soochow University, Suzhou Dushu Lake Hospital, Suzhou, China
| | - Cheng Ren
- Department of Cardiology, The First people’s Hospital of Zhangjiagang, Affiliated Hospital of Soochow University, Medical Center of Soochow University, Zhangjiagang, Jiangsu, China
| | - Xiaofei Mei
- Department of Cardiology, The Fourth Affiliated Hospital of Soochow University, Medical Center of Soochow University, Suzhou Dushu Lake Hospital, Suzhou, China
| | - Yufeng Jiang
- Department of Cardiology, The Fourth Affiliated Hospital of Soochow University, Medical Center of Soochow University, Suzhou Dushu Lake Hospital, Suzhou, China
- Institute for Hypertension, Soochow University, Suzhou, China
| | - Yafeng Zhou
- Department of Cardiology, The Fourth Affiliated Hospital of Soochow University, Medical Center of Soochow University, Suzhou Dushu Lake Hospital, Suzhou, China
- Institute for Hypertension, Soochow University, Suzhou, China
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Yang K, Kwon S, Burton-Murray H, Kuo B, Chan AT, Field AE, Staller K. Maladaptive weight control and eating behaviours in female adolescents/young adults are associated with increased risk of irritable bowel syndrome in adulthood: Results from the Growing Up Today Study (GUTS). Aliment Pharmacol Ther 2024; 60:934-939. [PMID: 39102895 PMCID: PMC11524775 DOI: 10.1111/apt.18197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 04/09/2024] [Accepted: 07/25/2024] [Indexed: 08/07/2024]
Abstract
BACKGROUND Irritable bowel syndrome (IBS) is common among individuals with eating disorders. The relationship between these conditions is likely bidirectional. However, data on the risk of IBS among those with prior eating disorders is largely limited to cross-sectional studies. AIM To prospectively evaluate the association between maladaptive weight control/eating behaviours in females during adolescence/young adulthood with subsequent IBS using the Growing Up Today Study (GUTS). METHODS Starting in 1996 (age: 9-14) and during follow-up, participants reported frequency of maladaptive eating/weight control behaviours during the past year to lose weight: self-induced vomiting (n = 5740), laxative use (n = 5438), and fasting (n = 5522) in addition to reporting binge eating (n = 4459). Starting in 2001 and during follow-up, participants reported if they had ever been diagnosed with an eating disorder (n = 5316). Incident IBS cases were identified from four questionnaire cycles (2013, 2014, 2016, 2019), with participants specifying the year of diagnosis if occurring before the questionnaire date. Multivariable logistic regressions adjusting for age, body mass index, and depressive symptoms estimated the associations of interest. RESULTS Maladaptive weight control/eating behaviours were associated with increased IBS risk [ORs (95% CIs) for laxatives to lose weight = 3.67 (2.52-5.35), vomiting to lose weight = 1.83 (1.29-2.60), fasting to lose weight = 2.62 (1.86-3.70), and bingeing = 2.25 (1.54-3.28)] as was history of eating disorder diagnosis [OR (95% CI) = 3.42 (2.38-4.90)]. The magnitude of IBS risk increased with the frequency of maladaptive behaviours. CONCLUSIONS There is evidence for the potential role of early maladaptive weight control/eating behaviours in the development of adult IBS among females.
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Affiliation(s)
- Keming Yang
- Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
- Clinical and Translational Epidemiology Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Sohee Kwon
- Clinical and Translational Epidemiology Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Helen Burton-Murray
- Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Braden Kuo
- Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Andrew T. Chan
- Clinical and Translational Epidemiology Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Alison E. Field
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Kyle Staller
- Clinical and Translational Epidemiology Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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Kulin D, Shah A, Fairlie T, Wong RK, Fang X, Ghoshal UC, Kashyap PC, Mulak A, Lee YY, Talley NJ, Koloski N, Jones MP, Holtmann GJ. The COVID-19 pandemic as a modifier of DGBI symptom severity: A systematic review and meta-analysis. Neurogastroenterol Motil 2024; 36:e14878. [PMID: 39056447 DOI: 10.1111/nmo.14878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 06/24/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND This SRMA reviewed and assessed the changes in the severity of disorders of gut-brain interaction (DGBI) symptoms during the COVID-19 pandemic, and evaluated factors associated with symptom severity changes. METHODS Electronic databases were searched until February 2024, for articles reporting on changes in symptom severity in DGBI patients during the COVID-19 pandemic. The proportion of DGBI patients who reported a change in their symptom severity were pooled using a random-effects model, and subgroup analyses were conducted to assess the effect of socio-cultural modifiers on symptom severity in DGBI. KEY RESULTS Twelve studies including 3610 DGBI patients found that 31.4% (95% CI, 15.9-52.5) of DGBI patients experienced symptom deterioration, while 24.3% (95% CI, 10.2-47.5) experienced improvement. Countries with high gross domestic product (GDP) had a 43.5% (95% CI, 16.3-75.2) likelihood of symptom deterioration, compared to 9.2% (95% CI, 1.4-42.2) in lower GDP countries. Similarly, countries with low COVID fatality rates had a 60.1% (95% CI, 19.7-90.3) likelihood of symptom deterioration, compared to 18.3% (95% CI, 7.8-36.9) in higher fatality rate countries. Countries with lenient COVID policies had a 58.4% (95% CI, 14.1-92.3) likelihood of symptom deterioration, compared to 19% (95% CI, 8.2-38.1) in countries with stricter policies. Patients in high vaccine hesitancy countries had a 51.4% (95% CI, 19.5-82.2) likelihood of symptom deterioration, compared to 10.6% (95% CI, 2.7-33.4) in low vaccine hesitancy countries. CONCLUSIONS & INFERENCES This meta-analysis reveals that a significantly higher proportion of DGBI patients experienced deterioration of symptoms during the COVID-19 pandemic. Various sociocultural, economic and environmental factors potentially modify the effects of the COVID-19 pandemic on DGBI.
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Affiliation(s)
- Dmitrii Kulin
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Translational Research Institute, Brisbane, Queensland, Australia
- Department of Gastroenterology & Hepatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Ayesha Shah
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Translational Research Institute, Brisbane, Queensland, Australia
- Department of Gastroenterology & Hepatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Thomas Fairlie
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Translational Research Institute, Brisbane, Queensland, Australia
- Department of Gastroenterology & Hepatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Reuben K Wong
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Xiucai Fang
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Uday C Ghoshal
- Institute of Gastrosciences and Liver Transplantation, Apollo Multispeciality Hospitals, Kolkata, India
| | - Purna C Kashyap
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Agata Mulak
- Department of Gastroenterology and Hepatology, Wroclaw Medical University, Wroclaw, Poland
| | - Yeong Yeh Lee
- School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- GI Function & Motility Unit, Hospital Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Nicholas J Talley
- School of Medicine and Public Health, and Hunter Medical Research Institute, The University of Newcastle, Newcastle, New South Wales, Australia
| | - Natasha Koloski
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Translational Research Institute, Brisbane, Queensland, Australia
- Department of Gastroenterology & Hepatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Michael P Jones
- Macquarie University, School of Psychological Sciences, Sydney, New South Wales, Australia
| | - Gerald J Holtmann
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Translational Research Institute, Brisbane, Queensland, Australia
- Department of Gastroenterology & Hepatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
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Zhang X, Jin WW, Wang HG. Correlation between the neuroendocrine axis, microbial species, inflammatory response, and gastrointestinal symptoms in irritable bowel syndrome. World J Gastroenterol 2024; 30:3985-3995. [PMID: 39351052 PMCID: PMC11438665 DOI: 10.3748/wjg.v30.i35.3985] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Revised: 08/22/2024] [Accepted: 09/02/2024] [Indexed: 09/13/2024] Open
Abstract
BACKGROUND This study examines the complex relationships among the neuroendocrine axis, gut microbiome, inflammatory responses, and gastrointestinal symptoms in patients with irritable bowel syndrome (IBS). The findings provide new insights into the pathophysiology of IBS and suggest potential therapeutic targets for improving patient outcomes. AIM To investigate the interactions between the neuroendocrine axis, gut microbiome, inflammation, and gastrointestinal symptoms in patients with IBS. METHODS Patients diagnosed with IBS between January 2022 and January 2023 were selected for the study. Healthy individuals undergoing routine check-ups during the same period served as the control group. Data were collected on neuroendocrine hormone levels, gut microbiome profiles, inflammatory biomarkers, and gastrointestinal symptomatology to analyze their interrelations and their potential roles in IBS pathogenesis. RESULTS IBS patients exhibited significant dysregulation of the neuroendocrine axis, with altered levels of cortisol, serotonin, and neuropeptides compared to healthy controls. The gut microbiome of IBS patients showed reduced diversity and specific alterations in bacterial genera, including Bifidobacterium, Lactobacillus, and Faecalibacterium, which were associated with neuroendocrine disturbances. Additionally, elevated levels of inflammatory markers, such as C-reactive protein, interleukin-6, and tumor necrosis factor-α, were observed and correlated with the severity of gastrointestinal symptoms like abdominal pain, bloating, and altered bowel habits. CONCLUSION The findings suggest that targeting the neuroendocrine axis, gut microbiome, and inflammatory pathways may offer novel therapeutic strategies to alleviate symptoms and improve the quality of life in IBS patients.
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Affiliation(s)
- Xin Zhang
- Department of Gastroenterology, Tongde Hospital of Zhejiang Province, Taizhou 524333, Zhejiang Province, China
| | - Wei-Wei Jin
- Department of Nutrition, Tongde Hospital of Zhejiang Province, Taizhou 524333, Zhejiang Province, China
| | - Hong-Gang Wang
- Department of Gastroenterology, Taizhou Municipal Hospital, Taizhou 524333, Zhejiang Province, China
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Wang B, Cheng P, Jin B, Jiang Y, Wang Q, Xu H. Effect of Tryptophan Restriction in the Therapy of Irritable Bowel Syndrome: a Systematic Review. Int J Gen Med 2024; 17:4141-4151. [PMID: 39308964 PMCID: PMC11414632 DOI: 10.2147/ijgm.s474525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 08/20/2024] [Indexed: 09/25/2024] Open
Abstract
Background & Aims The metabolic pathways of tryptophan (TRP) have been implicated in the pathophysiology of irritable bowel syndrome (IBS), positing that the strategic modulation of TRP consumption may exert regulatory effects on serotonin levels, consequently altering the clinical manifestation of IBS. This systematic review was meticulously orchestrated to evaluate the effect of TRP restriction on IBS. Methods A comprehensive search of the MEDLINE/PubMed, Cochrane Library, and Embase databases was conducted. Controlled trials that compared the efficacy of TRP restriction in IBS patients were scrutinized. The primary outcomes were gastrointestinal symptoms, quality of life, and pain, whereas the secondary outcomes included anxiety, mood, and safety. The risk of bias was meticulously assessed according to the guidelines recommended by the Cochrane Collaboration. Results A total of five trials, enrolling 135 participants, were incorporated into the qualitative synthesis. Low-TRP intake attenuated gastrointestinal discomfort and enhanced psychological well-being in IBS patients, while the effects of acute TRP depletion were controversial. Safety data from one randomized controlled trial reported no occurrence of adverse events. Conclusion This systematic review suggests that moderating, rather than depleting, TRP intake may potentially be a feasible and safe adjunctive treatment for patients with IBS. Future research incorporating a high-quality study design and consensus on clinical outcome measurements for IBS is warranted.
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Affiliation(s)
- Ben Wang
- Department of Gastroenterology, The Affiliated Taian City Central Hospital of Qingdao University, Taian, People’s Republic of China
- Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People’s Republic of China
| | - Peilin Cheng
- Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People’s Republic of China
| | - Bingjie Jin
- Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People’s Republic of China
| | - Ying Jiang
- Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People’s Republic of China
| | - Qingcai Wang
- Department of Gastroenterology, The Affiliated Taian City Central Hospital of Qingdao University, Taian, People’s Republic of China
| | - Hongwei Xu
- Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People’s Republic of China
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Jia F, Du L, He J, Zhang Z, Hou X, Dong Q, Bian Z, Zhao L. Tong-Xie-Yao-Fang strengthens intestinal feedback control of bile acid synthesis to ameliorate irritable bowel syndrome by enhancing bile salt hydrolase-expressing microbiota. JOURNAL OF ETHNOPHARMACOLOGY 2024; 331:118256. [PMID: 38677571 DOI: 10.1016/j.jep.2024.118256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 04/12/2024] [Accepted: 04/23/2024] [Indexed: 04/29/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE A herbal formula Tong-Xie-Yao-Fang (TXYF) is traditionally used to treat irritable bowel syndrome (IBS), modern pharmacological evidence supports that the formula efficacy is associated with altered gut microbiota. Yet, the mechanistic role of gut microbiota in the therapy of TXYF remains unclear. We previously clarified that gut microbiota-dysregulated bile acid (BA) metabolism contribute to the pathogenesis of IBS, deriving a hypothesis that microbiota-BA metabolic axis might be a potential target of TXYF. AIM OF THE STUDY We aim to investigate a new gut microbiota-mediated mechanism underlying anti-IBS efficacy of TXYF. MATERIALS AND METHODS We established an IBS rat model with a combination of stressors, compared the herbal efficacy in models undergone gut bacterial manipulations, also examined BA metabolism-related microbiota, metabolites, genes and proteins by 16S rRNA gene sequencing, targeted metabolomics, qPCR and multiplex immunofluorescence staining. RESULTS We observed that TXYF attenuated visceral hyperalgesia and diarrhea in IBS rats but not in those underwent gut bacteria depletion. Transferring gut microbiota from TXYF-treated donors also decreased visceral sensitivity and slightly relief diarrhea-like behaviors in IBS recipient rats. Fecal 16S rRNA gene sequencing revealed that TXYF modulated microbial β-diversity and taxonomic structure of IBS rats, with a significant increase in relative abundance of bile salt hydrolase (BSH)-expressing Bacteroidaceae. qPCR and culturing data validated that TXYF had a promotive effect on the growth and BSH activity of Bacteroides species. TXYF-reshaped microbiota upregulated the expression of intestinal Fgf15, a feedback signal to control BA synthesis in the liver. As a result, the BA synthetic and excretory levels in IBS rats were decreased by TXYF, so as that colonic BA membrane receptor Tgr5 sensing and its mediated Calcitonin gene-related peptide (Cgrp)-positive neuronal response were attenuated. CONCLUSION This study poses a new microbiota-driven therapeutic action for TXYF, highlighting the potential of developing new anti-IBS strategies from the herbal formula targeting BSH-expressing gut bacteria.
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Affiliation(s)
- Fengjing Jia
- School of Integrative Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Liqing Du
- School of Integrative Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jinchao He
- Department of Anorectal Surgery, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Zhaozhou Zhang
- School of Integrative Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xinxin Hou
- School of Integrative Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Qinjun Dong
- Department of Anorectal Surgery, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Zhaoxiang Bian
- Centre for Chinese Herbal Medicine Drug Development, Hong Kong Baptist University, Hong Kong SAR, China.
| | - Ling Zhao
- School of Integrative Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
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Ionescu VA, Gheorghe G, Georgescu TF, Bacalbasa N, Gheorghe F, Diaconu CC. The Latest Data Concerning the Etiology and Pathogenesis of Irritable Bowel Syndrome. J Clin Med 2024; 13:5124. [PMID: 39274340 PMCID: PMC11395839 DOI: 10.3390/jcm13175124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2024] [Revised: 08/23/2024] [Accepted: 08/27/2024] [Indexed: 09/16/2024] Open
Abstract
Globally, irritable bowel syndrome (IBS) is present in approximately 10% of the population. While this condition does not pose a risk of complications, it has a substantial impact on the patient's quality of life. Moreover, this disease has a significant financial impact on healthcare systems. This includes the direct costs associated with the diagnosis and treatment of these patients, as well as the indirect costs that arise from work absenteeism and reduced productivity. In light of these data, recent research has focused on elucidating the pathophysiological basis of this condition in order to improve the quality of life for affected individuals. Despite extensive research to date, we still do not fully understand the precise mechanisms underlying IBS. Numerous studies have demonstrated the involvement of the gut-brain axis, visceral hypersensitivity, gastrointestinal dysmotility, gut microbiota dysbiosis, food allergies and intolerances, low-grade mucosal inflammation, genetic factors, and psychosocial factors. The acquisition of new data is crucial for the advancement of optimal therapeutic approaches aimed at enhancing the general health of these patients while simultaneously reducing the financial burden associated with this ailment.
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Affiliation(s)
- Vlad Alexandru Ionescu
- Faculty of Medicine, University of Medicine and Pharmacy Carol Davila Bucharest, 050474 Bucharest, Romania
- Internal Medicine Department, Clinical Emergency Hospital of Bucharest, 105402 Bucharest, Romania
| | - Gina Gheorghe
- Faculty of Medicine, University of Medicine and Pharmacy Carol Davila Bucharest, 050474 Bucharest, Romania
- Internal Medicine Department, Clinical Emergency Hospital of Bucharest, 105402 Bucharest, Romania
| | - Teodor Florin Georgescu
- Faculty of Medicine, University of Medicine and Pharmacy Carol Davila Bucharest, 050474 Bucharest, Romania
- General Surgery Department, Clinical Emergency Hospital of Bucharest, 105402 Bucharest, Romania
| | - Nicolae Bacalbasa
- Department of Visceral Surgery, Center of Excellence in Translational Medicine, Fundeni Clinical Institute, 022328 Bucharest, Romania
| | | | - Camelia Cristina Diaconu
- Faculty of Medicine, University of Medicine and Pharmacy Carol Davila Bucharest, 050474 Bucharest, Romania
- Internal Medicine Department, Clinical Emergency Hospital of Bucharest, 105402 Bucharest, Romania
- Academy of Romanian Scientists, 050085 Bucharest, Romania
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Craven MR, Thakur ER. The integration of complementary and integrative health and whole person health in gastrointestinal disorders: a narrative review. Transl Gastroenterol Hepatol 2024; 9:75. [PMID: 39503019 PMCID: PMC11535803 DOI: 10.21037/tgh-23-121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 05/16/2024] [Indexed: 11/08/2024] Open
Abstract
Background and Objective Complementary and integrative health (CIH) approaches are increasingly popular among patients with gastrointestinal (GI) disorders. Whole person health has been identified as an important perspective in integrative health. While complementary approaches have been discussed in the GI literature, the whole person health framework has not yet been incorporated. Whole person health is particularly relevant as we shift to patient-centered care to facilitate holistic healing for this population. The aim of this paper is to apply a conceptualization of whole person health and its relevance in understanding how CIH approaches can be utilized for patients with stress-sensitive GI disorders, such as disorders of gut-brain interaction (DGBI) and inflammatory bowel disease (IBD). Methods Between July 2023 and December 2023 numerous major databases were reviewed to identify relevant articles for this narrative review. Keywords searched included (but not limited to) complementary alternative medicine, integrative medicine, DGBI, IBD, whole person health, and CIH categories (nutritional, mind-body, psychological). We limited our search to peer-reviewed English language articles. Studies were also cross-referenced to incorporate additional relevant studies. Key Content and Findings This narrative review describes how to integrate CIH approaches with whole person health for patients with some of the most common stress-sensitive GI disorders, including DGBIs and IBD. In each section, we highlight how each domain of the whole person health framework (biological, behavioral, social, environmental) can be addressed through CIH approaches: psychological, mind-body practices, and nutritional. Conclusions The integration of CIH approaches into the treatment of GI disorders is a growing area of interest that holds promise for enhancing patient outcomes. The two concepts of CIH and whole person health are harmonizing, and their integration serves to support patients who are already using CIH approaches, and providers who can facilitate shared-decision-making and patient-centered care. While not exhaustive, this review demonstrates positive associations between the use of CIH and beneficial outcomes across all whole person health domains for patients with GI disorders.
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Affiliation(s)
| | - Elyse R. Thakur
- Section on General Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Section of Gastroenterology and Hepatology, Atrium Health, Charlotte, NC, USA
- Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
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Wang K, Wang S, Chen X. The Causal Effects between Mood Swings and Gastrointestinal Diseases: A Mendelian Randomization Study. ALPHA PSYCHIATRY 2024; 25:533-540. [PMID: 39360292 PMCID: PMC11443280 DOI: 10.5152/alphapsychiatry.2024.241688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 07/02/2024] [Indexed: 10/04/2024]
Abstract
Background Numerous studies have examined the links between mental disorders such as depression and bipolar disorder, and gastrointestinal (GI) diseases. However, few studies have investigated the link between mood swings and GI diseases. Given the impact of mood swings on various conditions and the growing comprehension of the gut-brain axis, this study aims to explore their causal relationship using Mendelian randomization (MR) methods. Methods Single-nucleotide polymorphisms (SNPs) associated with mood swings were obtained from a recent study. SNPs associated with GI diseases were identified from the FinnGen project. We conducted two-sample bidirectional MR analyses using three methods, primarily the inverse variance weighting (IVW) method. Furthermore, we performed sensitivity analyses and false discovery rate (FDR) analysis to validate the accuracy and robustness of the results. Results Bidirectional MR analysis revealed significant causal effects between mood swings and GI diseases according to the IVW method (odds ratio (OR): 1.213; 95% confidence interval (CI): 1.118-1.316; P = 3.490e-6; P FDR = 8.730e-5). Mood swings were linked to an increased risk for 11 of 24 diseases, including five upper GI diseases (gastroesophageal reflux disease (GERD), acute gastritis, gastroduodenal ulcer, duodenal ulcer, and functional dyspepsia), two lower GI diseases (diverticular disease of the intestine and irritable bowel syndrome (IBS)) and four hepatobiliary and pancreatic diseases (nonalcoholic fatty liver disease (NAFLD), chronic pancreatitis, acute pancreatitis, and pancreatic cancer). Inverse MR analysis showed no causal relationship between 24 GI diseases and mood swings. Conclusions This comprehensive MR analysis suggests that genetically predicted mood swings may be a risk factor in the development of GI diseases. Interventions for mood swings may help to treat GI diseases.
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Affiliation(s)
- Kaixin Wang
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Institute of Anesthesia and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Key Laboratory of Anesthesiology and Resuscitation, Huazhong University of Science and Technology, Ministry of Education, China
| | - Shuai Wang
- Department of Gastric and Colorectal Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Xiangdong Chen
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Institute of Anesthesia and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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So D, Tuck C. Innovative concepts in diet therapies in disorders of gut-brain interaction. JGH Open 2024; 8:e70001. [PMID: 39027160 PMCID: PMC11255864 DOI: 10.1002/jgh3.70001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 05/29/2024] [Accepted: 06/21/2024] [Indexed: 07/20/2024]
Abstract
Diet therapy in disorders of gut-brain interaction (DGBI) is rapidly advancing, with accumulating evidence to support two innovative therapies-manipulation of dietary fibers and enzyme supplementation-that target specific DGBI pathophysiology and modulate digestion. Dietary fibers escape digestion in the upper gastrointestinal tract and can influence gut function by impacting digestion, improving laxation, and interacting with the microbiota. A more nuanced understanding of different fiber types and their ability to impact gut function in highly specific ways has shown that fibers can impact distinct gut symptoms and pathophysiology. By considering their functional characteristics of bulking, gel-forming, and fermentability, restriction or supplementation of specific fibers can offer clinical value in DGBI. Similarly to fiber specificity, emerging evidence suggests that supplemental digestive enzymes may be targeted to known food triggers with consideration that enzymes are substrate specific. Limited evidence supports use of lactase to target lactose, and α-galactosidase to target galacto-oligosaccharides. Application of enzymes during manufacturing of food products may prove to be an additional strategy, although evidence is scant. Both innovative therapies may be utilized in isolation or in combination with other diet and nondiet therapies. Implementation can be guided by the principles that fiber modulation can be targeted to specific symptomology or requirement for alterations to gut function, and digestive enzymes can be targeted to known food triggers. This review aims to summarize recent literature of these two innovative concepts and provide practical suggestions for their implementation in clinical practice.
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Affiliation(s)
- Daniel So
- Department of GastroenterologyMonash University and Alfred HealthMelbourneAustralia
| | - Caroline Tuck
- Department of Nursing and Allied HealthSwinburne UniversityHawthornAustralia
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Ugboke JO, Uwumiro F, Okorigba EM, Lawal RA, Okpujie V, Ndulue C, Temple-Obi LO, Bassey EI, Hassan AE, Ozumba S. Unplanned 30-Day Readmissions After Hospitalization for Irritable Bowel Syndrome. Cureus 2024; 16:e64519. [PMID: 39139324 PMCID: PMC11321272 DOI: 10.7759/cureus.64519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2024] [Indexed: 08/15/2024] Open
Abstract
Background Irritable bowel syndrome (IBS) continues to pose significant healthcare challenges due to its broad differential diagnosis and the often extensive yet inconclusive workup. We investigated the rates and characteristics of unplanned 30-day readmissions in adult patients hospitalized with IBS. In addition, we identified factors that predict readmission within 30 days of initial discharge. Methods We analyzed the 2020 Nationwide Readmission Database. Using the International Classification of Diseases, Tenth Revision, Clinical Modification code, we identified hospitalizations in adult patients with IBS. We excluded hospitalizations for minors and planned or elective readmissions. To compare baseline characteristics between readmissions and index hospitalizations, χ2 tests were employed. We used multivariate Cox regression analyses to identify independent predictors of readmissions. Results A total of 5,729 adult hospitalizations with IBS as the primary diagnosis were discharged alive, and 638 (11.1%) readmissions occurred within 30 days. The most common diagnoses associated with readmission were noninfective gastroenteritis and colitis, sepsis, enterocolitis due to Clostridium difficile, and irritable bowel syndrome with or without diarrhea. Patients in readmissions had a mean age of 56.3 years, similar to index hospitalizations (54.5 years, p=0.093). Readmissions had a higher burden of comorbidity (Charlson comorbidity index (CMI) scores ≥3: 26.7%, 170 cases vs. 16.6%, 953 cases; p<0.001) and were mostly Medicare beneficiaries (49.5%, 316% vs. 44.9%, 2,578) compared with index hospitalizations. Readmissions had a longer mean length of stay (LOS) (5.2 vs. 3.6 days, p<0.0001), higher inpatient mortality (0.8%, 5% vs. 0.2%, 11; p=0.032), and higher mean hospital costs ($47,852 vs. $34,592; p<0.0001) compared with index admissions. Secondary diagnoses of ulcerative colitis (adjusted hazard ratio (AHR), 2.82; p<0.0001), interstitial cystitis (AHR, 5.37; p=0.007), peripheral vascular disease (AHR, 1.59; p=0.027), and discharge to short-term hospitals (AHR, 1.03; p<0.0001) were significantly associated with a higher likelihood of readmission within 30 days. Conclusion IBS readmissions have poorer outcomes than index hospitalizations. Patients with an existing history of ulcerative colitis, interstitial cystitis, and peripheral vascular disease and those discharged to short-term hospitals following index hospitalization are more likely to be readmitted within 30 days.
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Affiliation(s)
- Joshua O Ugboke
- Internal Medicine, College of Medicine, University of Lagos, Lagos, NGA
| | - Fidelis Uwumiro
- Internal Medicine, Our Lady of Apostles Hospital, Akwanga, NGA
| | | | - Ridwan A Lawal
- Internal Medicine, College of Medicine, University of Lagos, Lagos, NGA
| | | | | | - Love O Temple-Obi
- Internal Medicine, University of Abuja Teaching Hospital, Gwagwalada, NGA
| | - Emmanuel I Bassey
- Internal Medicine, College of Health Sciences, University of Uyo, Uyo, NGA
| | | | - Sara Ozumba
- Family Medicine, University of Nigeria, Enugu, NGA
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Xie P, Luo M, Fan J, Xiong L. Multiomics Analysis Reveals Gut Virome-Bacteria-Metabolite Interactions and Their Associations with Symptoms in Patients with IBS-D. Viruses 2024; 16:1054. [PMID: 39066219 PMCID: PMC11281411 DOI: 10.3390/v16071054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 06/23/2024] [Accepted: 06/27/2024] [Indexed: 07/28/2024] Open
Abstract
The gut microbiota is involved in the pathogenesis of diarrhea-predominant irritable bowel syndrome (IBS-D), but few studies have focused on the role of the gut virome in IBS-D. We aimed to explore the characteristics of the gut virome in patients with IBS-D, its interactions with bacteria and metabolites, and the associations between gut multiomics profiles and symptoms. This study enrolled twelve patients with IBS-D and eight healthy controls (HCs). The stool samples were subjected to metavirome sequencing, 16S rRNA gene sequencing, and untargeted metabolomic analysis. The participants completed relevant scales to assess the severity of their gastrointestinal symptoms, depression, and anxiety. The results revealed unique DNA and RNA virome profiles in patients with IBS-D with significant alterations in the abundance of contigs from Siphoviridae, Podoviridae, Microviridae, Picobirnaviridae, and Tombusviridae. Single-omics co-occurrence network analyses demonstrated distinct differences in the gut virus, bacteria, and metabolite network patterns between patients with IBS-D and HCs. Multiomics networks revealed that short-chain fatty acid-producing bacteria occupied more core positions in IBS-D networks, but had fewer links to viruses. Amino acids and their derivatives exhibit unique connectivity patterns and centrality features within the IBS-D network. The gastrointestinal and psychological symptom factors of patients with IBS-D were highly clustered in the symptom-multiomics network compared with those of HCs. Machine learning models based on multiomics data can distinguish IBS-D patients from HCs and predict the scores of gastrointestinal and psychological symptoms. This study provides insights into the interactions among gut viruses, bacteria, metabolites, and clinical symptoms in patients with IBS-D, indicating further classification and personalized treatment for IBS-D.
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Affiliation(s)
| | | | | | - Lishou Xiong
- Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
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Mo N, Yang Y, Wang W, Zhou P, Liu F, Zhang Y, Zhang J, Han L, Lu C. Causal associations between psoriasis, eczema, urticaria, and mental illness: A bidirectional Mendelian randomization study of the European population. Medicine (Baltimore) 2024; 103:e38586. [PMID: 38941419 PMCID: PMC11466097 DOI: 10.1097/md.0000000000038586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Accepted: 05/23/2024] [Indexed: 06/30/2024] Open
Abstract
Observational studies have reported a relationship between multiple common dermatoses and mental illness. To assess the potential bidirectional causality between 3 skin disorders (psoriasis, eczema, and urticaria) and 4 psychiatric disorders (bipolar disorder, schizophrenia, major depressive disorder, and anxiety) in the European population, we used Mendelian randomization (MR) analysis, which provides definitive evidence for causal inference. Eligible single nucleotide polymorphisms were screened for dermatological and psychiatric disorders using a genome-wide association study database. We conducted bidirectional, 2-sample MR analysis using instrumental variables related to psoriasis, eczema, and urticaria as exposure factors, and bipolar disorder, schizophrenia, major depression, and anxiety as outcomes. Reverse MR analysis with bipolar disorder, schizophrenia, major depression, and anxiety as exposure and psoriasis, eczema, and urticaria as outcomes were also performed, and the causality was analyzed using inverse-variance weighting (IVW), MR-Egger, and weighted median methods. To thoroughly assess causality, sensitivity analyses were conducted using the IVW, MR-PRESSO, and MR-Egger methods. The results showed that bipolar disorder increased the incidence of psoriasis (odds ratio = 1.271, 95% confidence interval = 1.003-1.612, P = .047), heterogeneity test with Cochran Q test in the IVW showed P value > .05, (P = .302), the MR-Pleiotropy and MR-PRESSO (outlier methods) in the multiplicity test showed P value > .05, (P = .694; P = .441), and MR-Pleiotropy evidence showed no apparent intercept (intercept = -0.060; SE = 0.139; P = .694). Major depression increased the risk of eczema (odds ratio = 1.002, 95% confidence interval = 1.000-1.004, P = .024), heterogeneity test showed P value > .05, (P = .328), multiplicity detection showed P value > .05, (P = .572; P = .340), and MR-Pleiotropy evidence showed no apparent intercept (intercept = -0.099; SE = 0.162; P = .572). Sensitivity analyses of the above results were reliable, and no heterogeneity or multiplicity was found. This study demonstrated a statistically significant causality between bipolar disorder and psoriasis, major depression, and eczema in a European population, which could provide important information for physicians in the clinical management of common skin conditions.
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Affiliation(s)
- Nian Mo
- The Second Clinical College of Guangzhou University of Chinese Medicine in Guangzhou, Guangzhou, China
| | - Yujie Yang
- The Second Clinical College of Guangzhou University of Chinese Medicine in Guangzhou, Guangzhou, China
| | - Wen Wang
- The Second Clinical College of Guangzhou University of Chinese Medicine in Guangzhou, Guangzhou, China
| | - Panyu Zhou
- The Second Clinical College of Guangzhou University of Chinese Medicine in Guangzhou, Guangzhou, China
| | - Fanlu Liu
- The Second Clinical College of Guangzhou University of Chinese Medicine in Guangzhou, Guangzhou, China
| | - Yating Zhang
- Dongguan Hospital of Guangzhou University of Chinese Medicine, Dongguan, China
| | - Junhong Zhang
- The Second Clinical College of Guangzhou University of Chinese Medicine in Guangzhou, Guangzhou, China
| | - Ling Han
- The Second Clinical College of Guangzhou University of Chinese Medicine in Guangzhou, Guangzhou, China
- State Key Laboratory of TCM Moisture Syndrome at the Second Affiliated Hospital of Guangzhou University of Chinese Medicine in Guangzhou, Guangzhou, China
- Guangdong-Hong Kong-Macao Joint Laboratory of TCM and Immune Disease Research in Guangzhou, Guangzhou, China
- Guangdong Province Hospital of Chinese Medicine in Guangzhou, Guangzhou, China
| | - Chuanjian Lu
- The Second Clinical College of Guangzhou University of Chinese Medicine in Guangzhou, Guangzhou, China
- State Key Laboratory of TCM Moisture Syndrome at the Second Affiliated Hospital of Guangzhou University of Chinese Medicine in Guangzhou, Guangzhou, China
- Guangdong-Hong Kong-Macao Joint Laboratory of TCM and Immune Disease Research in Guangzhou, Guangzhou, China
- Guangdong Province Hospital of Chinese Medicine in Guangzhou, Guangzhou, China
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