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Resumen Los trastornos gastrointestinales funcionales (TGF) son enfermedades crónicas que configuran un problema relevante en la salud pública, asociados en investigaciones previas a una peor calidad de vida. El objetivo del presente trabajo fue estudiar la calidad de vida en pacientes que acuden a un servicio de neurogastroenterología en un hospital de Argentina y compararlo con población control. Para ello, se realizó un estudio cuantitativo y transversal incluyendo población clínica diagnosticada con algún TGF (n = 35) y una muestra control sin diagnóstico de TGF (n = 37). Se encontraron diferencias significativas entre personas con TGF y sujetos control, X 2 (1, N = 70) = 30.23,p < .001 en todas las subdimensiones de la escala de calidad de vida (MQLI), exceptuando satisfacción espiritual (PE). Similar a investigaciones previas, los resultados de este estudio sugieren que, en Argentina -al igual que en otros países-, los individuos con TGF muestran una peor percepción de calidad de vida que la población general. Estos hallazgos podrían contribuir al diseño de intervenciones que contemplen variables biopsicosociales, con el objetivo de una mejoría integral en la calidad de vida de las personas que padecen estos trastornos.
Abstract Functional Gastrointestinal Disorders (FGDS) are chronic diseases that constitute a relevant public health problem, associated in previous research with a poorer quality of life. The aim of this study was to study the quality of life in patients attending a Neurogastroenterology Service at an Argentinean public hospital and compare it with a control population. A quantitative and cross-sectional study was carried out including a clinical population diagnosed with some FGD (n = 35) and a control sample without diagnosis of FGD (n = 37). Significant differences were found between people with FGD and control subjects, X 2 (1, N = 70) = 30.23, p < .001 in all sub-dimensions of the Quality of Life Index (MQLI), except Spiritual Fulfillment (SF). Similar to previous research, the results of this study suggest that individuals with FGD show a worse perception of quality of life than the general population. These findings could contribute to the design of interventions that contemplate biopsychosocial variables, with the aim of a comprehensive improvement in the quality of life of people with these disorders.
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Objective:To explore the intervention effect of Shumu Peitu herb-partitioned moxibustion on clinical signs and symptoms and negative emotions of diarrhea-predominant irritable bowel syndrome (IBS-D) patients with liver-stagnation and spleen-deficiency pattern.Methods:A total of 72 patients with IBS-D of liver-stagnation and spleen-deficiency pattern treated in the Department of Gastroenterology of Nanjing Vniversity of Chinese Medicine from September 2021 to June 2022 were selected for randomized controlled trial. The patients were randomly divided into the observation group (2 cases dropped off, 34 cases in total) and control group (1 case dropped off, 35 cases in total) by random number table method. The patients in control group were treated with Tongxieyaofang (TXYF). The patients in observation group were treated with oral administration of TXYF and Shumu Peitu herb-partitioned moxibustion, and both groups were treated for 4 weeks. The clinical efficacy, Traditional Chinese Medicine (TCM) syndrome integral, IBS Quality of Life Questionnaire (IBS-QOL), IBS Symptom Severity Scale (IBS-SSS), Bristol Stool Form Scale and Hospital Anxiety and Depression Scale (HADS) were compared before and after treatment.Results:After treatment, the total effective rate of the observation group was 94.12%(32/34), which was higher than the 71.43%(25/35) in the control group, the difference was significant ( χ2 = 6.18, P<0.05). After treatment, the TCM syndrome integral in the observation group was (7.62 ± 4.08), which was lower than the (9.89 ± 4.71) in the control group, the difference was significant ( t = 2.14, P<0.05). After treatment of 3 days, the scores of quality of life in the five dimensions of dysthymia, behavior disorder, health worry, avoidance of eating and social function in the observation group were (82.44 ± 11.46), (80.25 ± 11.67), (76.23 ± 12.67), (59.80 ± 15.14) and (79.23 ± 11.59) points, which were different with the (73.57 ± 12.39), (72.35 ± 15.48), (69.76 ± 13.11), (50.00 ± 16.17) and (73.04 ± 13.11) points in the control group, the difference were significant ( t values were -3.09 - -2.08, all P<0.05). Three days after treatment, the score of IBS-SSS and Bristol fecal character in the observation group were (118.24 ± 40.64) and (5.09 ± 0.62) points, which were lower than the (146.86 ± 60.09) and (5.51 ± 0.66) points in the control group, the difference were significant ( t = 2.31 and 2.76, both P<0.05). After treatment, the score of HADS-A and HADS-D in the observation group were (6.26 ± 1.75) and (5.29 ± 1.47), which were different with the (7.26 ± 2.19) and (6.17 ± 2.11) in the control group, the difference were significant ( t = 2.08 and 2.00, both P<0.05). Conclusions:Shumu Peitu herb-partitioned moxibustion can effectively improve IBS-D patients with liver-stagnation and spleen-deficiency pattern, relieve clinical symptoms, reduce negative emotions, and improve quality of life.
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Irritable bowel syndrome is a common functional gastrointestinal disorder, among which diarrhea-type irritable bowel syndrome (IBS-D) is the main type in China, which is seriously affecting the quality of life for patients. The pathogenesis of IBS-D is still unclear. It has been found that Intestinal flora disorder is an important pathogenesis of IBS-D. There is a close relationship between intestinal flora and IBS-D TCM syndrome types, and there are differences in intestinal flora of different TCM syndrome types of IBS-D. However, TCM syndrome types are a complex and multi-factor combination. Therefore, based on the TCM theory of nature and location of disease, this article proposed the following conclusions through analyzing previous studies on intestinal flora of different TCM syndromes of IBS-D, including that the intestinal flora of different TCM syndromes have different characteristics and there are differences in the functions of flora, deficiency and excess of disease are associated with the diversity and abundance of intestinal flora, cold and heat of disease are related to the proportion of beneficial bacteria and opportunistic pathogens, and the characteristics of intestinal flora are the microcosmic manifestation of the disease position of TCM. In addition, this article also proposed the application of fecal bacteria transplantation based on the theory of nature and location of disease. Based on this theory, the study on intestinal flora of IBS-D can provide help for objectification of TCM syndrome types, and also provide TCM research ideas for revealing the pathogenesis of IBS-D.
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It is the hotspot that studying the interplay and mechanism between intestinal flora metabolites and diseases.Deoxycholic acid, one of the intestinal flora metabolites, is one of the most abundant secondary bile acids in human intestinal tract, which is corelated with many diseases, while the mechanisms remain unclear.The imbalance of deoxycholic acid is connected with the intestinal flora disorder and high fat diet, which could result in several immunoreaction and inflammatory reaction.In this review, the interaction between deoxycholic acid and digestive diseases in children, such as non-alcoholic fatty liver disease, inflammatory bowel disease and irritable bowel syndrome, is discussed to explore their related mechanism, so as to clarify the direction of further study on the influence of intestinal microbiota metabolites deoxycholic acid on the human body.
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OBJECTIVE To comprehensively evaluate the effectiveness， safety and economics of linaclotide in the treatment of constipated irritable bowel syndrome （IBS-C）， and to provide the evidence-based basis for clinical application. METHODS Rapid health technology assessment method was adopted； PubMed， Embase， the Cochrane Library， Web of Science， CNKI， Wanfang data， VIP database， SinoMed， and related HTA websites were searched. Systematic review/meta-analysis， HTA reports and pharmacoeconomic research about linaclotide were collected. After literature screening， data extraction and quality evaluation， descriptive analysis was used to classify and summarize the research results. RESULTS A total of 11 literature were included， involving 7 systematic reviews/meta-analyses and 4 pharmacoeconomic research. In terms of effectiveness， compared with placebo， linaclotide could achieve FDA specified endpoint and European Medicines Agency-recommended endpoint faster， significantly improved patients’ complete spontaneous bowel movements （CSBM）， abdominal pain， constipation and quality of life， and relieved patients’ global symptoms； compared with the indirect evidence of lubiprostone， plecanatide and tenapanor， the efficacy of linaclotide at the FDA specified endpoint， CSBM， abdominal pain relief， and global relief response were the best. In terms of safety， the incidence of overall adverse drug reactions， diarrhea and flatulence caused by linaclotide were significantly higher than placebo，but patients can tolerate them. In terms of economics， compared with traditional therapeutic drugs， linaclotide showed an economic advantage. CONCLUSIONS Linaclotide has advantages in efficacy， safety and economics in the treatment of IBS-C. It is an effective strategy for the treatment of IBS-C.
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OBJECTIVE To investigate the effects of Cistanches Herba polysaccharides （abbreviated as CDPS） on rats with constipation-predominant irritable bowel syndrome （IBS-C）. METHODS SD rats were divided into control group （20 rats） and modeling group. The modeling group was given 2 mL of normal saline at 0-4 ℃ intragastrically （once a day， for 14 consecutive days） to induce IBS-C model. After modeling， model rats were grouped into model group， positive control group （mosapride citrate， 1.35 mg/kg）， CDPS low-dose group （50 mg/kg） and CDPS high-dose group （100 mg/kg）， with 20 rats in each group. Administration groups were given corresponding drug solution intragastrically， and control group and model group were given a constant volume of water intragastrically， once a day， for 28 consecutive days. The fecal water content， serum content of 5-hydroxytryptamine （5-HT）， and charcoal powder propulsion rate of rats were determined in each group；the pathological morphology of colon tissue was observed， and mRNA and protein expressions of nerve growth factor （NGF） and tropomyosin receptor kinase A （TrkA） in colon tissue were detected. RESULTS Compared with control group， the fecal water content and carbon powder propulsion rate in the model group were decreased significantly （P＜0.05）； the rupture of mucosal muscle layer in colon tissue， significant infiltration of inflammatory cells and cellular edema were observed； the content of 5-HT in serum， and relative mRNA and protein expressions of NGF and TrkA were increased significantly （P＜0.05）. Compared with model group， the fecal water content and carbon powder propulsion rate of rats were increased significantly in administration groups （P＜0.05）， and pathological changes of colon tissue were relieved significantly， while the content of 5-HT in serum， the mRNA and protein expressions of NGF and TrkA in colon tissue were decreased significantly （P＜0.05）； among them， the above indicators inthe positive control group and CDPS high-dose group were generally close to those in the control group （P＞0.05）. CONCLUSIONS CDPS can alleviate the symptoms of IBS-C rats， which may be related to the inhibition of NGF/TrkA signaling pathway.
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Irritable bowel syndrome （IBS） is a functional gastrointestinal disease， but it often causes extreme gastrointestinal discomfort and prolonged illness， which seriously affects the quality of life of patients. The global incidence rate is increasing year by year. Clinically， western medicine mainly uses oral antispasmodics， secretagogues， and antidepressants， but there are many disadvantages such as adverse reactions and poor long-term efficacy. Therefore， finding an efficient and safe treatment method is an urgent problem to be solved. A large number of studies have shown that traditional Chinese medicine has definite curative and long-lasting effects on the treatment of IBS， which has become a hot research direction in recent years. By searching Chinese and foreign literature， it is found that electroacupuncture， moxibustion， Chinese medicine monomers， and compound decoctions are the main methods in the mechanism research of traditional Chinese medicine in the treatment of IBS-related pathways， and their signaling pathways involve nuclear transcription factor kappa B （NF-κB）， transient receptor potential vanillin subfamily 1 （TRPV1）， 5-hydroxytryptamine （5-HT）， mitogen-activated protein kinase （MAPK）， and so on. Traditional Chinese medicine can repair intestinal inflammation， reduce visceral sensitivity， enhance intestinal mucosal barrier， and regulate intestinal motility by regulating this series of signaling pathways， thereby playing an important role in the treatment of IBS with multi-level， multi-link and multi-target characteristics. Based on the cell signaling pathways， this paper reviewed the research progress on the mechanism of traditional Chinese medicine in the treatment of IBS， hoping to provide theoretical support and diagnosis and treatment ideas for the clinical treatment of IBS with traditional Chinese medicine.
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The gut microbiome shows changes under a plateau environment, while the disbalance of intestinal microbiota plays an important role in the pathogenesis of irritable bowel syndrome (IBS); however, the relationship between the two remains unexplored. In this work, we followed up a healthy cohort for up to a year before and after living in a plateau environment and performed 16S ribosomal RNA (rRNA) sequencing analysis of their fecal samples. Through evaluating the participants' clinical symptoms, combined with an IBS questionnaire, we screened the IBS sub-population in our cohort. The sequencing results showed that a high-altitude environment could lead to changes in the diversity and composition of gut flora. In addition, we found that the longer the time volunteers spent in the plateau environment, the more similar their gut microbiota composition and abundance became compared to those before entering the plateau, and IBS symptoms were significantly alleviated. Therefore, we speculated that the plateau may be a special environment that induces IBS. The taxonomic units g_Alistipes, g_Oscillospira, and s_Ruminococcus_torques, which had been proved to play important roles in IBS pathogenesis, were also abundant in the IBS cohort at high altitudes. Overall, the disbalance of gut microbiota induced by the plateau environment contributed to the high frequency of IBS and the psychosocial abnormalities associated with IBS. Our results prompt further research to elucidate the relevant mechanism.
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Irritable bowel syndrome (IBS) is a common refractory disease. Chinese medicine (CM) has remarkable efficacy and advantages on the treatment of IBS. This review summarized the articles focusing on the treatment of IBS with CM to sum up the latest treatment methods for IBS and the underlying mechanisms. Literature analysis showed that prescriptions, acupuncture, and moxibustion are the primary methods of CM treatment for IBS. The potential mechanism centers on the regulation of the enteric nervous system, the alleviation of visceral hypersensitivity, the stability of intestinal flora, and the regulation of the immune system.
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Humans , Irritable Bowel Syndrome/therapy , Medicine, Chinese Traditional , Acupuncture Therapy/methods , MoxibustionABSTRACT
OBJECTIVE@#To observe the effects of moxibustion on the stem cell factor (SCF)/tyrosine kinase receptor (c-kit) signaling pathway and immune function in rats with diarrhea irritable bowel syndrome (IBS-D), and to explore the mechanism of moxibustion for IBS-D.@*METHODS@#Among 52 young rats born from 6 healthy pregnant SPF rats, 12 rats were randomly selected into the normal group, and the remaining 40 rats were treated with the three-factor combination method of maternal separation, acetic acid enema and chronic restraint stress to establish the IBS-D rat model. Thirty-six rats with successful IBS-D model were randomly divided into a model group, a moxibustion group, and a medication group, 12 rats in each group. The rats in the moxibustion group were treated with suspension moxibustion at "Tianshu" (ST 25) and "Shangjuxu" (ST 37); the rats in the medication group were treated with intragastric administration of rifaximin suspension (150 mg/kg). All the treatments were given once a day for 7 consecutive days. The body mass, loose stool rate (LSR), the minimum volume threshold when abdominal withdrawal reflex (AWR) scored 3 were measured before acetic acid enema (35 days old), after modeling (45 days old), and after intervention (53 days old). After intervention (53 days old), HE staining was used to observe the morphology of colon tissue, and spleen and thymus coefficients were measured; ELISA method was used to detect serum inflammatory factors (tumor necrosis factor a [TNF-a], interleukin [IL]-10, IL-8), T-lymphocyte subsets (CD+4, CD+8, CD+45), value of CD+4/CD+8 and immune globulin (IgA, IgG, IgM); real-time PCR method and Western blot method was used to detect the expression of SCF, c-kit mRNA and protein in colon tissue; immunofluorescence staining method were used to detect positive expression of SCF and c-kit.@*RESULTS@#After intervention, compared with the normal group, in the model group, the body mass and the minimum volume threshold when AWR scored 3 were decreased (P<0.01), LSR, spleen and thymus coefficients, serum levels of TNF-α, IL-8, CD+4, CD+45, CD+4/CD+8, IgA, IgG, IgM were increased (P<0.01), serum IL-10 level and protein and mRNA expression of SCF and c-kit in colon tissue were decreased (P<0.01), and the positive expression of SCF and c-kit was decreased (P<0.01). Compared with the model group, in the moxibustion group and the medication group, the body mass and the minimum volume threshold when AWR scored 3 were increased (P<0.01, P<0.05), LSR, spleen and thymus coefficients, serum levels of TNF-α, IL-8, CD+4, CD+8, CD+45, CD+4/CD+8, IgA, IgG, IgM were decreased (P<0.01, P<0.05), serum IL-10 level and protein and mRNA expression of SCF and c-kit in colon tissue were increased (P<0.01), and the positive expression of SCF and c-kit was increased (P<0.01). Compared with the medication group, in the moxibustion group, the level of serum CD+4 was decreased (P<0.05), the value of CD+4/CD+8 was increased (P<0.01), and there was no significant difference in other indexes (P>0.05). The expression of SCF and c-kit mRNA was positively correlated with the minimum volume threshold when AWR scored 3 and IL-10 (P<0.01), and negatively correlated with remaining indexes (P<0.01, P<0.05).@*CONCLUSION@#Moxibustion could reduce visceral hypersensitivity, improve symptoms of abdominal pain and diarrhea in IBS-D rats, and its mechanism may be related to up-regulation of the expression of SCF/c-kit signaling pathway and improvement of IBS-D immune function.
Subject(s)
Rats , Animals , Irritable Bowel Syndrome/therapy , Moxibustion/methods , Rats, Sprague-Dawley , Interleukin-10 , Interleukin-8 , Maternal Deprivation , Tumor Necrosis Factor-alpha , Diarrhea , Signal Transduction , Homeostasis , Receptor Protein-Tyrosine Kinases , Immunity , Immunoglobulin A , Immunoglobulin MABSTRACT
ABSTRACT Introduction: the persistence of long-term symptoms of COVID-19 represents a new challenge for the medical-scientific community, it is the condition called long-term COVID-19. Irritable Bowel Syndrome (IBS) is one of the most common Disorders of the Gut-Brain Interaction and its post-infection development is already validated. According to the Rome IV criteria, it is characterized by the presence of recurrent abdominal pain, on average, at least 1 day a week in the last 3 months with onset of symptoms at least 6 months before diagnosis, associated with 2 or more factors: related to defecation and/or associated with change in stool frequency and/or associated with change in stool form. This study aimed to review data on post-COVID-19 IBS. Methods: this is an integrative review of studies published between January 1, 2020 and April 30, 2023, which presented data on IBS with previously diagnosed COVID-19 disease. The PubMed database was used, the descriptors were "Irritable bowel syndrome" AND "COVID-19"; the reference list of the articles was also retrieved. Results: eight studies were reviewed, it was observed that 0.6% to 11.6% of patients had IBS again after a minimum period of 6 months of infection. Risk factors were female gender, severity of COVID-19, presence of acute-phase gastrointestinal symptoms, and depression/anxiety. Conclusion: the results obtained suggest that COVID-19 may be associated with the emergence of de novo IBS. Further studies are needed to investigate its long-term effects and clinical spectra.
RESUMO Introdução: a persistência de sintomas a longo prazo da COVID-19 representa um novo desafio à comunidade médico-científica, é a condição denominada COVID-19 longo. A Síndrome do Intestino Irritável (SII) é um dos Distúrbios da Interação Intestino Cérebro mais comuns e seu desenvolvimento pós-infecção já é validado. Segundo os critérios de Roma IV, caracteriza-se por presença de dor abdominal recorrente, em média, pelo menos 1 dia por semana nos últimos 3 meses com início dos sintomas pelo menos 6 meses antes do diagnóstico, associada a 2 ou mais fatores: relacionada à defecação e/ou associada com mudança na frequência das fezes e/ou associada com mudança na forma das fezes. Este estudo teve como objetivo revisar dados acerca de SII pós-COVID-19. Métodos: trata-se de uma Revisão Integrativa de estudos publicados entre 1º de janeiro de 2020 a 30 de abril de 2023, que apresentassem dados acerca de SII com a doença COVID-19 previamente diagnosticada. Utilizou-se a base de dados PubMed, os descritores foram "Irritable bowel syndrome" AND "COVID-19"; a lista de referência dos artigos também foi recuperada. Resultados: oito estudos foram revisados, observou-se que 0,6% a 11,6% pacientes cursaram com SII de novo após um período mínimo de 6 meses da infecção. Os fatores de risco foram sexo feminino, gravidade da COVID-19, presença de sintomas gastrointestinais de fase aguda e depressão/ansiedade. Conclusão: os resultados obtidos permitem crer que a COVID-19 pode estar associada ao surgimento de SII de novo. São necessários outros estudos para investigar seus efeitos a longo prazo e espectros clínicos..
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OBJECTIVE@#To compare the clinical efficacy between herbal-moxa plaster and moxa-box moxibustion for diarrhea type irritable bowel syndrome (IBS-D) of spleen and kidney yang deficiency.@*METHODS@#Eighty patients with IBS-D of spleen and kidney yang deficiency were randomly divided into a herbal-moxa plaster group and a moxa-box moxibustion group, 40 cases in each group. The patients in the two groups were treated with conventional acupuncture at Baihui (GV 20), Yintang (GV 24+), Zhongwan (CV 12) and bilateral Tianshu (ST 25), Yinlingquan (SP 9), and Taixi (KI 3), etc. In addition, the patients in the herbal-moxa plaster group were treated with herbal-moxa plaster (Wenyang Fuzheng ointment, composed of prepared monkshood, prepared evodia rutaecarpa, dried ginger, cinnamon, etc.) at Shenque (CV 8), Guanyuan (CV 4), Zhongwan (CV 12) and bilateral Tianshu (ST 25), Shenshu (BL 23) and Shangjuxu (ST 37); the patients in the moxa-box moxibustion group were treated with moxa-box moxibustion at the same acupoints as the herbal-moxa plaster group. The acupuncture-moxibustion treatment was provided once every other day for 4 weeks (14 treatments). Before and after treatment, the scores of clinical symptom of TCM, irritable bowel syndrome (IBS) symptom severity scale (IBS-SSS) and IBS quality of life scale (IBS-QOL) were compared between the two groups, and the clinical efficacy was evaluated.@*RESULTS@#Compared with those before treatment, each item scores and total scores of clinical symptom of TCM, and IBS-SSS scores in the two groups were reduced after treatment (P<0.05). The abdominal bloating score, stool frequency score and total score of clinical symptom of TCM as well as IBS-SSS score in the herbal-moxa plaster group were lower than those in the moxa-box moxibustion group (P<0.05). Compared with those before treatment, the IBS-QOL scores in the two groups were increased after treatment (P<0.05), and the IBS-QOL score in the herbal-moxa plaster group was higher than that in the moxa-box moxibustion group (P<0.05). The total effective rate was 92.5% (37/40) in the herbal-moxa plaster group, which was higher than 85.0% (34/40) in the moxa-box moxibustion group (P<0.05).@*CONCLUSION@#On the basis of conventional acupuncture treatment, herbal-moxa plaster could effectively improve the clinical symptoms and quality of life in IBS-D patients of spleen and kidney yang deficiency, and its efficacy is superior to that of moxa-box moxibustion.
Subject(s)
Humans , Spleen , Irritable Bowel Syndrome/drug therapy , Quality of Life , Yang Deficiency/drug therapy , Kidney , DiarrheaABSTRACT
ObjectiveTo investigate the mechanism of Magnolia officinalis cortex for constipation-type irritable bowel syndrome（IBS-C） rats before and after sweating. MethodIBS-C rat model was established by gavage of ice water， and rats were randomly divided into the blank group， model group， mosapride group（1 mg·kg-1）， M. officinalis cortex group（10 g·kg-1） and sweated M. officinalis cortex group（10 g·kg-1）. The changes of body weight， fecal number and fecal water content of rats were observed， 16S rRNA sequencing was used to detect the structural changes of fecal intestinal flora in rats， the levels of 5-hydroxytryptamine（5-HT） and substance P（SP） in colonic tissues of rats were determined by enzyme-linked immunosorbent assay（ELISA）. ResultCompared with the model group， the fecal water content and fecal number of mosapride group， M. officinalis cortex group and sweated M. officinalis cortex group were significantly increased（P<0.05）. At the phylum level， the top four species of flora abundance were Firmicutes， Bacteroidetes， Spirochaetes and Proteobacteria. Compared with the blank group， the proportion of Firmicutes in the model group was significantly reduced（P<0.05）， while the proportion of Spirochaetes was significantly increased（P<0.05）. Compared with the model group， the proportion of Firmicutes and Spirochaetes in M. officinalis cortex group and sweated M. officinalis cortex group tended to be similar to that in the blank group， and the proportion of Spirochaetes in sweated M. officinalis cortex group was lower than that of M. officinalis cortex group. At the family level， the top four species of flora abundance were Lactobacillaceae， S24_7， Ruminococcaceae， Bacteroidaceae， compared with the blank group， the proportion of Lactobacillaceae in the model group decreased significantly（P<0.05）， and its proportion in the M. officinalis cortex group and sweated M. officinalis cortex group increased significantly after administration（P<0.05）， and the flora structure of the two groups tended to be similar to that of the blank group. At the genus level， the top four species of flora abundance were Lactobacillus， Unspecified_S24_7， Bacteroides and Treponema. Compared with the blank group， the proportion of Lactobacillus in the model group decreased significantly（P<0.05）， while the proportion of Treponema increased significantly（P<0.05）. Compared with the model group， ratio of bacterial structure of Lactobacillus and Treponema in the M. officinalis cortex group and sweated M. officinalis cortex group tended to be similar to those in the blank group， indicating that M. officinalis cortex could restore the intestinal microbial structure of IBS-C rats before and after sweating. Compared with the model group， the 5-HT content in mosapride group was significantly reduced（P<0.05）， the contents of 5-HT and SP in the M. officinalis cortex group and sweated M. officinalis cortex group were significantly increased（P<0.01）， and the sweated M. officinalis cortex group was higher than the M. officinalis cortex group. ConclusionM. officinalis cortex can play a therapeutic role on IBS-C rats by regulating 5-HT pathway and intestinal flora structure before and after sweating.
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ObjectiveTo investigate the mechanism of Akkermansia muciniphila （A. muciniphila） regulating the visceral hypersensitivity in irritable bowel syndrome （IBS） rats induced by neonatal maternal separation （MS） and water avoidance stress （WAS）. MethodsNeonatal male Sprague-Dawley rats were randomly divided into sham WAS group （blank group）， MS+WAS group （IBS model group） and A. muciniphila group. IBS model was established by MS combined with WAS in both IBS model group and A. muciniphila group. Meanwhile， the rats in the A. muciniphila group were given 1 mL 1×109 CFU/mL A. muciniphila by gavage daily for 10 days. Visceral pain responses were detected by behavioral observations and abdominal withdrawal reflex scores. ResultsCompared with IBS model group， A. muciniphila group exhibited significant increase of body weight and visceral pain threshold， significantly decreased numbers of fecal particles and proportions of unformed stools， significantly higher expression levels of cannabinoid receptor type 2 （CB2R） mRNA in colon tissues. ConclusionA. muciniphila may alleviate the visceral hypersensitivity in IBS rats by regulating the expression of CB2R mRNA in colonic tissues.
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Diarrhea-predominant irritable bowel syndrome （IBS-D） is a chronic functional bowel disorder characterized by abdominal pain and diarrhea， with visceral hypersensitivity and abnormal gastrointestinal dynamics as the pathophysiological basis. The brain-gut interaction plays a role in pain-related functional gastrointestinal disorders， especially IBS-D. 5-Hydroxytryptamine （5-HT）， as an important brain-gut peptide regulating gastrointestinal function， affects brain activity， gastrointestinal motility， pain perception， mucosal inflammation， and immune response through brain-gut interaction and is associated with the occurrence and development of IBS-D. In recent years， traditional Chinese medicine （TCM） has shown great potential to mitigate gastrointestinal symptoms and improve the quality of life with its holistic view and treatment based on syndrome differentiation. Studies have shown that TCM treats IBS-D by regulating the 5-HT signaling pathway. With a focus on syndrome differentiation in TCM， this paper systematically describes the efficacy and mechanism of TCM in treating different TCM syndromes of IBS-D via the 5-HT signaling pathway， aiming to provide a scientific basis for TCM treatment of this disease.
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Blastocystis is a common unicellular intestinal protozoa in humans and animals, and the most common clinical manifestations of infections include abdominal pain and diarrhea. Based on the sequence of the small-subunit ribosomal RNA (SSU rRNA) gene, 28 subtypes of B. hominis (ST1 to ST17, ST21 and ST23 to ST32) have been characterized. Previous studies have demonstrated that B. hominis infection is strongly associated with inflammatory bowel disease (IBD), irritable bowel syndrome (IBS) and other intestinal diseases, which threatens the health and quality of life among patients with B. hominis infection and is considered as an important public health problem. This review summarizes the progress of researches on B. hominis infection among IBD and IBS patients during the past 20 years, so as to provide insights into management of blastocystosis in China.
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Objective: To observe the effect of moxibustion on behaviors and related products of tryptophan (Trp) metabolism in the colon of mice with irritable bowel syndrome (IBS), and to explore the mechanism of moxibustion in the IBS treatment.Methods: Twenty-four mice were randomly divided into a normal group, a model group, a moxibustion group, and a probiotic group, with 6 mice in each group. The visceral pain model of IBS was established by enema with 2,4,6-trinitrobenzene sulfonic acid (TNBS) solution. Mice in the moxibustion group were treated with mild moxibustion at bilateral Zusanli (ST36), and those in the probiotic group were treated with probiotics such as Bifidobacterium by gavage. Abdominal withdrawal reflex (AWR) test, elevated plus-maze (EPM) test, and forced swimming test (FST) were performed after treatment. The expression levels of 5-hydroxytryptamine (5-HT) and tryptophan hydroxylase 1 (TPH1) in the colon were detected by immunofluorescence, and the expression levels of Trp, kynurenine (Kyn), and indole-2,3-oxygenase (IDO) in the colon were detected by enzyme-linked immunosorbent assay. Results: Compared with the normal group, the AWR scores were increased significantly in the model group under different pressure values (P<0.01), the open-arm staying time and open-arm entries in the EPM test were decreased significantly (P<0.01, P<0.05), the motionless time in the FST was increased significantly (P<0.01), and the expression levels of colonic Trp, TPH1, IDO, 5-HT, and Kyn were increased significantly (P<0.01) in the models. Compared with the model group, the AWR scores were differently decreased (P<0.05 or P<0.01), the open-arm entries in the EPM test were increased (P<0.05), the motionless times in the FST were decreased (P<0.05), and the colonic expression levels of Trp, TPH1, IDO, and 5-HT were decreased (P<0.01 or P<0.05) in the moxibustion and probiotic groups; the open-arm staying time was significantly increased in the moxibustion group (P<0.01), and the colonic expression level of Kyn was significantly decreased in the probiotic group (P<0.01). Conclusion: Moxibustion at Zusanli (ST36) improves visceral pain and pain mood and down-regulates the expression levels of colonic TPH1, IDO, Trp, 5-HT, and Kyn in IBS mice.
ABSTRACT
Irritable bowel syndrome (IBS) is characterized by abdominal pain associated with changes in defecation frequency and blood folate level. FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols. High-FODMAP diet could elicit or exacerbate IBS-associated bowel symptoms, which is inadequately recognized among gastroenterologists in China. Here we report an IBS case, focusing on the association between high-FODMAP diet and bowel symptoms and the intervention of low-FODMAP diet.
ABSTRACT
Resumen El síndrome de intestino irritable (SII) es un trastorno caracterizado por cambios en el hábito intestinal y afecta al 30% de la población mundial. Aunque se ha encontrado una conexión entre el eje cerebro-microbiota intestinal, el desarrollo del SII y su asociación con la prevalencia de trastornos mentales, las posibles implicaciones que tienen en el hábito alimentario de las personas no son claras. Este artículo tuvo como objetivo explorar la relación entre el estrés, depresión, ansiedad, trastornos mentales y hábitos alimentarios en pacientes con SII. Se realizó una exploración bibliográfica en los motores de búsqueda PubMed, ScienceDirect y BVS. Se encontró que las personas con SII pueden presentar anormalidades en la microestructura cerebral y alteraciones en la red cerebro-intestino asociadas a una mayor duración de los síntomas gastrointestinales y el aumento de la comorbilidad afectiva. También se sugiere una relación en distintas vías entre el estrés, depresión y ansiedad, síntomas de SIII y cambios en los hábitos de alimentación. Todo lo anterior puede motivar prácticas de alimentación restrictivas, cambios en el apetito, subadecuación de nutrientes incluso en algunos casos por el mismo manejo nutricional y, en general, deterioro de la calidad de vida de las personas con SII. Se sugiere un manejo integral que no solo implique un manejo farmacológico para los síntomas de SII y los estados de ansiedad y depresión, sino que también incluya un manejo psicológico, manejo nutricional personalizado y recomendaciones de mejora de los estilos de vida como la práctica de actividad física y manejo del estrés.
Abstract Irritable bowel syndrome (IBS) is a disorder characterized by changes in bowel habits and affects 30% of the world's population. Although a connection has been found between the brain-gut microbiota axis, the development of IBS, and its association with the prevalence of mental disorders, the possible implications for people's eating habits are unclear. This article aimed to explore the relationship between stress, depression, anxiety, mental disorders, and eating habits in patients with IBS. A literature search was conducted in the PubMed, ScienceDirect, and VHL search engines. We found that people with IBS may have abnormalities in the brain microstructure and alterations in the brain-gut network associated with a longer duration of gastrointestinal symptoms and increased affective comorbidity. A relationship between stress, depression and anxiety, IBS symptoms, and changes in eating habits in different pathways is also suggested. All these may lead to restrictive eating practices, changes in appetite, nutrient inadequacy, even due to the same nutritional management in some cases, and, generally, deterioration in the quality of life of people with IBS. We recommend comprehensive management that involves not only pharmacological treatment for IBS symptoms and states of anxiety and depression but also psychological therapy, personalized nutrition, and improving lifestyles, such as physical activity and stress management.
ABSTRACT
Introdução: O intestino é um órgão vital, entretanto, seu mau funcionamento pode gerar alguns distúrbios como por exemplo, "A síndrome do intestino irritável". O quadro desses pacientes são dores na barriga, inchaço abdominal e alteração na frequência das evacuações e na consistência das fezes. A fisioterapia tem apresentado meios que favorecem analgesia. Objetivo: Verificar os efeitos da Estimulação Elétrica Nervosa Transcutânea (TENS) e do Ultrassom (US) nos sintomas da síndrome do intestino irritável. Método: Foi utilizado o TENS na região abdominal, durante 15 minutos. O Ultrassom foi usado durante 3 minutos em cada região abdominal, somando 12 minutos ao total. O tratamento foi realizado durante um mês, com 9 sessões. Utilizou-se a Escala Visual Analógica (EVA) e o questionário Inflammatory Bowel Disease Questionnaire (IBDQ). Resultados: Nos sintomas intestinais obteve-se progresso de 5 pontos no questionário IBDQ e nos sintomas emocionais houve uma evolução de 9 pontos, sendo este, estatisticamente significante. Na escala EVA a média de escore diminui de 5,6 para 3,6 ao final da intervenção. Conclusão: A intervenção fisioterapêutica surtiu efeitos positivos e contribuiu para a diminuição da dor e os outros sintomas como: inchaço abdominal e diminuição na quantidade de evacuações e essa evolução auxiliou na qualidade de vida do voluntário.
Introduction: The intestine is a vital organ, however, due to its malfunction, some disorders appear, for example, "The irritable bowel syndrome", patients with this syndrome experience pain in the belly, abdominal swelling, changes in the frequency of bowel movements and stool consistency. Physiotherapy uses means that help to cause analgesia. Objective: To verify the effects of TENS and Ultrasound on the symptoms of the individual with irritable bowel syndrome, contributing to the quality of life. Method: TENS was used in the abdominal region in Burst mode with a frequency of 150Hz with amplitude until it caused a slight contraction, for 15 minutes. Ultrasound was used in continuous mode with a frequency of 1MHZ, with a dose of 0.5w / cm2, for 3 minutes in each abdominal region, adding 12 minutes to the total. The treatment was carried out for one month, with 9 sessions. The EVA scale and the IBDQ questionnaire were used. Results: In the intestinal symptoms there was an improvement of 5 points in the IBDQ questionnaire and in the emotional aspect there was an improvement of 9 points and in the emotional aspect it was statistically significant, passing through the Wilcoxon test, P (est.) = 0.031 P (exact) ) = 0.031. On the EVA scale, the mean score before the intervention was 5.6 and at the end 3.6. Conclusion: The physical therapy intervention had positive effects, helping to reduce pain and other symptoms such as:abdominal swelling, decrease in the amount of bowel movements and this improvement helped the individual's emotional state, however a study on the subject is still necessary.
Introducción: El intestino es un órgano vital, sin embargo, su mal funcionamiento puede generar algunos trastornos como el "síndrome del intestino irritable". Los síntomas de estos pacientes son dolor de estómago, hinchazón abdominal y alteración de la frecuencia de las deposiciones y de la consistencia de las heces. La fisioterapia ha presentado medios que favorecen la analgesia. Objetivo: Verificar los efectos de la Estimulación Nerviosa Eléctrica Transcutánea (TENS) y el Ultrasonido (US) en los síntomas del síndrome del intestino irritable. Método: Se utilizó TENS en la región abdominal durante 15 minutos. Los ultrasonidos se utilizaron durante 3 minutos en cada región abdominal, sumando 12 minutos en total. El tratamiento se llevó a cabo durante un mes, con 9 sesiones. Se utilizaron la Escala Visual Analógica (EVA) y el Cuestionario de Enfermedad Inflamatoria Intestinal (IBDQ). Resultados: En los síntomas intestinales hubo una progresión de 5 puntos en el cuestionario IBDQ y en los síntomas emocionales hubo una evolución de 9 puntos, siendo esto, estadísticamente significativo. En la escala VAS, la puntuación media disminuyó de 5,6 a 3,6 al final de la intervención. Conclusión: La intervención fisioterapéutica tuvo efectos positivos y contribuyó a la reducción del dolor y de otros síntomas como: hinchazón abdominal y disminución de la cantidad de deposiciones y esta evolución ayudó a la calidad de vida del voluntario.