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Hajiani E, Masjedizadeh A, Shayesteh AA, Babazadeh S, Seyedian SS. Comparison between gluten-free regime and regime with gluten in symptoms of patients with irritable bowel syndrome (IBS). J Family Med Prim Care 2019; 8:1691-1695. [PMID: 31198738 PMCID: PMC6559066 DOI: 10.4103/jfmpc.jfmpc_464_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Background and Objective Irritable bowel syndrome (IBS) is the most common gastrointestinal disorder and accounts for most of the referrals of patients to gastroenterologists. Given the high prevalence of this syndrome and its significant effect on the reduced quality of life of patients, the present study aimed to investigate the effect of using gluten-containing or gluten-free diet on symptoms of patients with irritable bowel syndrome. Materials and Methods In this trial, 140 patients with irritable bowel syndrome who referred to Imam Khomeini Hospital (2006) were randomly divided into two groups based on Rome III criteria. Seventy patients received a gluten-free diet and rest patent received a regular diet as control group for 12 weeks. In order to compare the quantitative characteristics, independent samples T-test was used, while Mann-Whitney and Z-tests were used to compare the qualitative characteristics. Findings There was no significant difference between the control group (9.8 ± 37 years) and the group with gluten-free diet (0.2 ± 37 years) in terms of mean age. The effect of gluten-free diet on intestinal gas, fecal consistency, urgent need for expulsion, and insufficient defecation were higher than in control group. Although abdominal pain and reduced frequency of bowel movements were higher in the control group than gluten-free diet group (P < 0.05). The positive response to general improvement in the gluten-free group and in the control group was 67% and 52%, respectively. Conclusion According to present results, providing gluten-free diet could be improved patient treatment's symptoms. Also, it seemed that the duration of treatment can lead to better therapeutic outcomes.
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Affiliation(s)
- Eskandar Hajiani
- Alimentary Tract Research Center, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran
| | - Abdolrahim Masjedizadeh
- Alimentary Tract Research Center, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran
| | - Ali Akbar Shayesteh
- Alimentary Tract Research Center, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran
| | - Sina Babazadeh
- Alimentary Tract Research Center, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran
| | - Seyed Saeid Seyedian
- Alimentary Tract Research Center, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran
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Sevostyanova EV, Nikolaev YA, Bogdankevich NV, Lusheva VG, Dolgova NA, Polyakov VY. [Combined rehabilitation in the patients presenting with dorsopathies of the lumbar spine and concomitant irritable bowel syndrome based at a therapeutic clinic]. Vopr Kurortol Fizioter Lech Fiz Kult 2018; 95:10-18. [PMID: 29786677 DOI: 10.17116/kurort201895210-18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 06/16/2017] [Accepted: 06/18/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND Comorbidity constitutes a serious challenge for rehabilitative medicine. The comorbidity of the dorsopathy of the lumbar spine and irritable bowel syndrome mutually complicates the clinical course of both conditions, significantly reduces the patients' quality of life. and increases the costs of diagnostic procedures and restoration of the working capacity. The approaches to the non-pharmacological management of the patients presenting with these diseases remain to be developed. AIMS The objective of the present study was to evaluate the effectiveness of the proposed combined non-medicinal rehabilitation modality which included a course of therapy with the application of modulated sinusoidal currents, total wrappings with the use of a Rapan saline solution, and sedative inhalations additionally introduced into the basic medicinal therapy of the patients presenting with dorsopathy of the lumbar spine combined with irritable bowel syndrome in the stationary phase. MATERIALS AND METHODS A total of 59 patients at the age from 20 to 65 years suffering from dorsopathy of the lumbar spine and concomitant irritable bowel syndrome were examined and treated. All the patients were randomized into two groups, the main (n=21) and control (n=38) one, matched for the sex and age. The patients in the control group received the conventional medical treatment in accordance with the adopted medical and economic standards during 2 weeks. The patients of the main group received, in addition to the basal medicinal therapy, the proposed combined rehabilitative physiotherapeutic treatment that included a course of therapy with modulated sinusoidal currents, total wrapping with the use of a Rapan saline solution, and sedative inhalations of the of peony root extract. The effectiveness of these rehabilitation modalities was monitored before and after the course of therapy based on the estimation of bowel function dynamics, the severity of pain syndrome, and the patient's quality of life in terms of the health status with the use of the SF-36 questionnaire. RESULTS The therapeutic and rehabilitative procedures resulted in a well apparent improvement of the genera condition in the patients of the main group associated with a greater degree of reduction of the incidence of specific clinical symptoms, more rapid relief of the pain syndrome, and a more pronounced improvement of the quality of life indices in comparison with the same variables in the patients comprising the control group. After the course of the treatment and rehabilitation, the incidence of spinal pain in the patients of the main group was significantly reduced by 87% (p=0.001) compared with those of the control group (32%; p=0.005). The frequency of abdominal pain decreased in the main group by 47% (p=0.021) versus the control group (by 27%; p=0.007). The quality of life indices increased 1.2 times in the main group but remained unaltered in the control group. DISCUSSION The patients of the main group exhibited a more pronounced than in the control group positive dynamics of health conditions characterized by a well apparent reduction in the incidence of the major clinical symptoms of the disease, faster alleviation of the pain syndrome, and the marked improvement of the quality of life indices. CONCLUSIONS The results of the study with the inclusion of therapy with modulated sinusoidal currents together with total wrapping using the Rapan saline solution and sedative inhalations into the program of the combined treatment of the patients presenting with dorsopathy of the lumbar spine and concomitant irritable bowel syndrome provide a basis for recommending this physiotherapeutic modality for personalized rehabilitation of this group of patients under conditions of a therapeutic clinic.
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Affiliation(s)
| | - Y A Nikolaev
- Research Institute of Experimental and Clinical Medicine
| | | | - V G Lusheva
- Research Institute of Experimental and Clinical Medicine
| | - N A Dolgova
- Research Institute of Experimental and Clinical Medicine
| | - V Y Polyakov
- Research Institute of Experimental and Clinical Medicine
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Ali A, Weiss TR, McKee D, Scherban A, Khan S, Fields MR, Apollo D, Mehal WZ. Efficacy of individualised diets in patients with irritable bowel syndrome: a randomised controlled trial. BMJ Open Gastroenterol 2017; 4:e000164. [PMID: 29018540 PMCID: PMC5628288 DOI: 10.1136/bmjgast-2017-000164] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 07/26/2017] [Accepted: 08/18/2017] [Indexed: 12/12/2022] Open
Abstract
Background Patients with irritable bowel syndrome (IBS) are often placed on diets guided by food intolerance assays, although these have not been validated. We assessed the effects of individualised diets in patients with IBS guided by a leucocyte activation test. Methods This is a parallel-group, double-blind, randomised controlled trial of 58 adults with IBS seen at an academic health centre in Northeast USA. Peripheral venous blood was analysed using a leucocyte activation test; individual foods were reported to produce positive or negative results. Participants were randomised to a 4-week diet with either individualised guidance to eliminate foods with positive assay results and allow foods with negative assay results (intervention), or with individualised guidance, matched in rigour and complexity, to eliminate foods with negative assay results and allow foods with positive assay results (comparison). The primary outcome was between-group differences in the IBS Global Improvement Scale (GIS). Secondary outcomes included reductions in IBS Symptom Severity Scale (SSS) scores and increases in IBS Adequate Relief (AR) and Quality of Life (QOL) scores. An aptamer-based proteomic analysis was conducted in strong responders. Results The intervention group had significantly greater increases in mean GIS score after 4 weeks (0.86 vs comparison; 95% CI 0.05 to 1.67; p=0.04) and 8 weeks (1.22 vs comparison; 95% CI 0.22 to 2.22; p=0.02). The intervention group also had significantly greater reductions in mean SSS score at 4 weeks (–61.78 vs comparison; 95% CI –4.43 to –119.14; p=0.04) and 8 weeks (–66.42 vs comparison; 95% CI –5.75 to –127.09; p=0.03). There were no significant differences between intervention and comparison groups in mean AR or QOL scores. A reduction in neutrophil elastase concentration was associated with reduced symptoms. Conclusions Elimination diets guided by leucocyte activation tests reduced symptoms. These findings could lead to insights into the pathophysiology of IBS. Trial registration number NCT02186743.
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Affiliation(s)
- Ather Ali
- School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Theresa R Weiss
- School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Douglas McKee
- Department of Economics, Cornell University, Ithaca, New York, USA
| | - Alisa Scherban
- School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Sumiya Khan
- School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Maxine R Fields
- School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Damian Apollo
- School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Wajahat Z Mehal
- School of Medicine, Yale University, New Haven, Connecticut, USA
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Chen G, Luo JX, Hu XY. Tiaoshen acupuncture for diarrhea type IBS in patients with chronic hepatitis B (liver stagnation and spleen deficiency syndrome): Curative effect and influence on plasma SP and VIP. Shijie Huaren Xiaohua Zazhi 2015; 23:1303-1307. [DOI: 10.11569/wcjd.v23.i8.1303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To assess the curative efficacy of Tiaoshen acupuncture for diarrhea type irritable bowel syndrome (IBS) in chronic hepatitis B (CHB) patients (liver stagnation and spleen deficiency syndrome) and its impact on serum levels of substance P (SP) and vasoactive intestinal peptide (VIP).
METHODS: One hundred and eight patients were randomly assigned to two groups (a treatment group and a control group) to receive both acupuncture and sham acupuncture treatment for 4 wk. The treatment group received acupuncture at gastric area and intestinal area of scalp acupuncture, and sham acupuncture at Tianshu, Zusanli, and Taichong. The control group were acupunctured at Tianshu, Zusanli, and Taichong, and sham-acupunctured at gastric area and intestinal area of scalp acupuncture. Traditional Chinese medicine (TCM) syndrome curative efficacy, TCM syndrome scores and serum levels of SP and VIP were evaluated before and after therapy.
RESULTS: A total of 96 patients (including 49 in the treatment group) completed the four-week study. Clinical curative effect in the treatment group was significantly better than that in the control group [89.80% (44/49) vs 65.96% (31/47), P < 0.05]. Compared with pretreatment values, TCM syndromes of both groups after treatment were decreased significantly [(26.4 ± 3.6) vs (8.5 ± 1.8); (25.3 ± 2.5) vs (15.6 ± 2.7)], while the treatment group showed a more significant decrease compared with the control group [(8.5 ± 1.8) vs (15.6 ± 2.7), P < 0.05]. After treatment, serum levels of SP and VIP in the two groups decreased significantly [SP: (43.68 ± 15.15) vs (22.08 ± 11.47); VIP: (45.24 ± 15.07) vs (34.52 ± 14.76)], and the decrease was more significant in the treatment group [SP: (38.44 ± 13.57) vs (16.31 ± 13.72); VIP: (37.13 ± 10.19) vs (25.47 ± 12.75), P < 0.05]. There were no adverse reactions or seroconversion in the study.
CONCLUSION: Tiaoshen acupuncture has a better clinical efficacy in CHB patients with diarrhea type IBS (liver stagnation and spleen deficiency syndrome) than traditional acupuncture treatment. Tiaoshen acupuncture may alleviate syndromes of CHB patients with diarrhea type IBS by altering serum levels of SP and VIP and thereby modulating intestine-brain responses.
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Agah S, Taleb AM, Moeini R, Gorji N, Nikbakht H. Cumin extract for symptom control in patients with irritable bowel syndrome: a case series. Middle East J Dig Dis 2013; 5:217-22. [PMID: 24829694 PMCID: PMC3990147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Accepted: 09/28/2013] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Irritable bowel syndrome is one of the most common gastrointestinal disordersCharacterized by chronic abdominal pain, altered bowel habits or changesin stool consistency. Unfortunately, no specific treatments for relieving IBSsymptoms have been suggested yet. This pilot study was conducted to evaluatethe efficacy of the Cumin extract, a kind of herbal used in the treatment of gastrointestinaldisorders like bloating, and other symptoms of IBS. METHODS Fifty seven patients with IBS (according to the ROME II diagnostic criteria)with no nay other accompanying illness enrolled in study. Patients wereadvised to discontinue their other treatments during the study course, then 20drops per day of Cumin essential oil was administered for included patients.IBS-associated symptoms including abdominal pain, nausea, painful defection,presence of mucosa in stool, changes in stool consistency and defecationfrequency were evaluated using a questionnairebefore treatment, 2 and4 weeks after beginning treatment and 2 and 4 weeks after stopping treatment. RESULTS Abdominal pain, bloating, incomplete defecation, fecal urgency and presenceof mucus discharge in stool were statistically significant decreased duringand after treatment with Cumin extract. Stool consistency and defecation frequencywere also both statistically significant improved in patients with constipationdominant pattern of IBS. CONCLUSION Cumin extract can be effective in improving all IBS symptoms. Consideringits low cost and easy availability Cumin administration in patients with IBSmay have economic benefits.
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Affiliation(s)
- Shahram Agah
- 1Assistant Professor, Internal Medicine Department, Rasoul Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran
,Corresponding Author: Shahram Agah, MD Assistant Professor, Internal Medicine Department Rasoul Akram Hospital, Tehran University of Medical Sciences Address: Rasoul Akram Hospital, Niyayesh St, Sattarkhan Ave, Tehran, Iran Telefax: +98 21 66516001
| | - Amir Mehdi Taleb
- 2Assistant Professor, Department of Pharmachology, Tehran University of Medical Sciences, Tehran, Iran
| | - Reyhane Moeini
- 3Researcher, Internal Medicine Department, Rasoul Akram Hospital, Tehran University of Medical Sciences,Tehran, Iran
| | - Narjes Gorji
- 3Researcher, Internal Medicine Department, Rasoul Akram Hospital, Tehran University of Medical Sciences,Tehran, Iran
| | - Hajar Nikbakht
- 3Researcher, Internal Medicine Department, Rasoul Akram Hospital, Tehran University of Medical Sciences,Tehran, Iran
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Magge S, Lembo A. Low-FODMAP Diet for Treatment of Irritable Bowel Syndrome. Gastroenterol Hepatol (N Y) 2012; 8:739-745. [PMID: 24672410 PMCID: PMC3966170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Functional bowel disorders, including irritable bowel syndrome (IBS), are common disorders that have a significant impact on patients' quality of life. These disorders present major challenges to healthcare providers, as few effective medical therapies are currently available. Recently, there has been increasing interest in dietary therapies for IBS, particularly a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs). Since ingestion of FODMAPs increases the delivery of readily fermentable substrates and water to the distal small intestine and colon-which results in luminal distention and gas-the reduction of FODMAPs in a patient's diet may improve functional gastrointestinal symptoms. This paper will review the pathophysiology of IBS and the role of FODMAPs for the treatment of this condition.
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Affiliation(s)
- Suma Magge
- Dr. Magge is a Fellow and Dr. Lembo is an Associate Professor of Medicine in the Division of Gastroenterology at Beth Israel Deaconess Medical Center in Boston, Massachusetts
| | - Anthony Lembo
- Dr. Magge is a Fellow and Dr. Lembo is an Associate Professor of Medicine in the Division of Gastroenterology at Beth Israel Deaconess Medical Center in Boston, Massachusetts
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Abstract
Irritable bowel syndrome is frustrating and debilitating for patients, and management of this disorder is a challenge for healthcare providers. IBS is a common, functional, gastrointestinal disorder, and is often characterized by crippling symptoms without any pathologic findings.
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Gaylord SA, Palsson OS, Garland EL, Faurot KR, Coble RS, Mann JD, Frey W, Leniek K, Whitehead WE. Mindfulness training reduces the severity of irritable bowel syndrome in women: results of a randomized controlled trial. Am J Gastroenterol 2011; 106:1678-88. [PMID: 21691341 PMCID: PMC6502251 DOI: 10.1038/ajg.2011.184] [Citation(s) in RCA: 158] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES This prospective, randomized controlled trial explored the feasibility and efficacy of a group program of mindfulness training, a cognitive-behavioral technique, for women with irritable bowel syndrome (IBS). The technique involves training in intentionally attending to present-moment experience and non-judgmental awareness of body sensations and emotions. METHODS Seventy-five female IBS patients were randomly assigned to eight weekly and one half-day intensive sessions of either mindfulness group (MG) training or a support group (SG). Participants completed the IBS severity scale (primary outcome), IBS-quality of life, brief symptom inventory-18, visceral sensitivity index, treatment credibility scale, and five-facet mindfulness questionnaire before and after treatment and at 3-month follow-up. RESULTS Women in the MG showed greater reductions in IBS symptom severity immediately after training (26.4% vs. 6.2% reduction; P=0.006) and at 3-month follow-up (38.2% vs. 11.8%; P=0.001) relative to SG. Changes in quality of life, psychological distress, and visceral anxiety were not significantly different between groups immediately after treatment, but evidenced significantly greater improvements in the MG than in the SG at the 3-month follow-up. Mindfulness scores increased significantly more in the MG after treatment, confirming effective learning of mindfulness skills. Participants' ratings of the credibility of their assigned interventions, measured after the first group session, were not different between groups. CONCLUSIONS This randomized controlled trial demonstrated that mindfulness training has a substantial therapeutic effect on bowel symptom severity, improves health-related quality of life, and reduces distress. The beneficial effects persist for at least 3 months after group training.
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Affiliation(s)
- Susan A. Gaylord
- Department of Physical Medicine and Rehabilitation, Program on Integrative Medicine, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Olafur S. Palsson
- Department of Medicine, Center for Functional Gastrointestinal and Motility Disorders and Division of Gastroenterology and Hepatology, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Eric L. Garland
- College of Social Work, Florida State University, Tallahassee, Florida, USA
| | - Keturah R. Faurot
- Department of Physical Medicine and Rehabilitation, Program on Integrative Medicine, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Rebecca S. Coble
- Department of Physical Medicine and Rehabilitation, Program on Integrative Medicine, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - J. Douglas Mann
- Department of Neurology, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - William Frey
- Training and Development, Offi ce of Human Resources, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Karyn Leniek
- Department of Physical Medicine and Rehabilitation, Program on Integrative Medicine, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - William E. Whitehead
- Department of Medicine, Center for Functional Gastrointestinal and Motility Disorders and Division of Gastroenterology and Hepatology, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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