• Humans
• Renal Insufficiency, Chronic/therapy
• Renal Insufficiency, Chronic/complications
• Renal Insufficiency, Chronic/physiopathology
• Gastrointestinal Diseases/therapy
• Gastrointestinal Diseases/etiology
• Renal Dialysis/adverse effects
• Quality of Life
• Probiotics/therapeutic use
• Gastrointestinal Microbiome/physiology

• R01 DK110871 NIDDK NIH HHS
• K23DK122015 NIDDK NIH HHS
• P30 AR072581 NIAMS NIH HHS
• K23 DK122015 NIDDK NIH HHS
• UL1 TR002529 NCATS NIH HHS
• T32 DK120524 NIDDK NIH HHS
• K23DK122015 NIDDK NIH HHS
• T32 DK120524 NIDDK NIH HHS

• Rome IV criteria
• irritable bowel syndrome
• mebeverine

• burnout
• healthcare staff
• irritable bowel syndrome
• prevalence
• severity

• Adolescent
• Adult
• Female
• Humans
• Male
• Middle Aged
• Young Adult
• Burnout, Professional/epidemiology
• Cross-Sectional Studies
• Health Personnel/psychology
• Health Personnel/statistics & numerical data
• Irritable Bowel Syndrome/epidemiology
• Saudi Arabia/epidemiology
• Students, Medical/psychology
• Students, Medical/statistics & numerical data
• Surveys and Questionnaires
• Severity of Illness Index

• complementary treatment
• conventional treatment
• dietary supplements
• gastrointestinal disease
• pediatric patients
• probiotics

• acupuncture
• anxiety
• depression
• irritable bowel syndrome with diarrhea
• network meta-analysis
• randomized controlled trials

• National Key Research and Development Program of China

• anorectal function
• autonomic dysfunction
• constipation
• irritable bowel syndrome
• slow deep breathing

There are about 10–23% of adults worldwide suffering from irritable bowel syndrome (IBS). Over the past few decades, there are many aspects of uncertainty regarding IBS leading to an ongoing interest in the topic as reflected by a vast number of publications, whose heterogeneity and variable quality may challenge researchers to measure their scientific impact, to identify collaborative networks, and to grasp actively researched themes. Accordingly, with help from bibliometric approaches, our goal is to assess the structure, evolution, and trends of IBS research between 2007 and 2022.

The documents exclusively focusing on IBS from 2007 to 2022 were retrieved from the Science Citation Index Expanded of the Web of Science Core Collection. The annual productivity of IBS research, and the most prolific countries or regions, authors, journals and resource-, intellectual- and knowledge-sharing in IBS research, as well as co-citation analysis of references and keywords were analyzed through Microsoft Office Excel 2019, CiteSpace, and VOSviewer.

In total, 4,092 publications were reviewed. The USA led the list of countries with the most publications (1,226, 29.96%). Mayo Clinic contributed more publications than any other institution (193, 4.71%). MAGNUS SIMREN stood out as the most active and impactful scholar with the highest number of publications and the greatest betweenness centrality value. The most high-yield journal in this field was Neurogastroenterology and motility: the official journal of the European Gastrointestinal Motility Society (275, 6.72%). Gastroenterology had the most co-citations (3,721, 3.60%). Keywords with the ongoing strong citation bursts were chromogranin A, rat model, peptide YY, gut microbiota, and low-FODMAP diet, etc.

Through bibliometric analysis, we gleaned deep insight into the current status of literature investigating IBS for the first time. These findings will be useful to scholars interested in understanding the key information in the field, as well as identifying possible research frontiers.

Irritable bowel syndrome (IBS) is a functional bowel disease that is characterized by abdominal pain, discomfort, and changes in the frequency and form of stool without any organic pathology. In this study, the factors that affect the herbal treatment choices of IBS patients and their results were investigated.

Included in the study were 248 IBS patients who were over the age of 18. A questionnaire that comprised 25 questions was applied to the participants. Survey questions were asked to the participants regarding their age, place of birth, gender, educational status, demographic details, social standing, socioeconomic status and job, place of residence, and marital status. In addition, The participants were asked about which IBS symptoms they had, from whom they had received the recommendation for use of herbal products, whether the media had an effect on their selection of herbal products, and whether they had benefited from herbal products.

It was observed that 41.1% of the patients with IBS who participated in the study used herbal medicine, 9.8% of whom used them regularly. It was found that the IBS patients participating in the study made their decision to use herbal products mostly based on the recommendations that they were given by acquaintances (57%) and the media (34%). When the patients were evaluated according to their gender, IBS was found to be more common in unemployed women who had a low level of education, while it was more common in working men (p = 0.015, P < 0.001, respectively). The IBS patients who were single used more herbal products that those who were married (P = 0.036). While the use of herbal herbs and oils was predominant in patients whose recommendation content comprised the media/internet and acquaintances, the herbal treatment content recommended by healthcare professionals consisted of traditional treatments and mixtures (P = 0.012). It was determined that a higher percentage of those who used herbal treatments lived in city centers when compared to those who did not (P < 0.001). In addition, it was determined that patients with constipation used herbal products more than those without (P < 0.001). Among the IBS patients, those who had diarrhea and those who were receiving medical treatment preferred to use significantly less herbal products (P = 0.007 and P = 0.041, respectively). It was found that the patients who visited the Gastroenterology Outpatient Clinic mostly used herbal therapy, while those who visited a family doctor used herbal therapy the least (P = 0.029 and P < 0.001, respectively).

The IBS patients revealed whose recommendations they followed when purchasing herbal products, which of the products they preferred, and how useful/beneficial they felt that these products were. In this regard, the addition of training curricula related to herbal treatment for professional healthcare workers will further raise awareness on this topic.

• Audio-visual media
• Herbal therapy
• Irritable bowel syndrome

• Anxiety and depression
• Fecal microbiota transplantation
• Irritable bowel syndrome
• Metagenome
• Short-chain fatty acids

• Biomarkers
• Brain-gut-microbiome axis
• Cognitive behavioral therapy
• Irritable bowel syndrome
• Neuroimaging
• Outcome prediction

• Brain-Gut Axis
• Cognitive Behavioral Therapy
• Gastrointestinal Microbiome
• Humans
• Irritable Bowel Syndrome/therapy
• RNA, Ribosomal, 16S/genetics

• P30 DK041301 NIDDK NIH HHS
• U54 DK123755 NIDDK NIH HHS
• R01 DK048351 NIDDK NIH HHS
• IK2 CX001717 CSRD VA
• U01 DK082370 NIDDK NIH HHS

• ERK
• JNK
• TLR4 signaling
• iNOS
• p38
• polymerase I and transcript release factor
• post-infectious irritable bowel syndrome

Plenty of clinical studies have suggested the value of Chinese herbal medicine (CHM) for patients with irritable bowel syndrome (IBS), but their efficacy and safety have not been systematically concluded yet. This article aimed to compare and rank the therapeutic effect and safety of CHM with routine pharmacotherapies and placebo in the treatment of IBS.

Randomized controlled trials regarding CHM to treat IBS were searched in six databases from inception to Jan 31, 2020. A network meta-analysis was conducted to analyze the data of included publications. The quality assessment was assessed by Cochrane Handbook and GRADEpro software. The risk ratio was calculated for dichotomous outcomes while the standardized mean difference was used for continuous variables with 95% credible intervals. A Funnel plot was performed to evaluate publication bias. The surface under the cumulative ranking curve was conducted to rank the included interventions. Data were analyzed with STATA 15.0 and Review Manager 5.3.

3194 records were searched, and 28 eligible trials involving 3323 patients ere identified. Compared with conventional therapies and placebo, Jianpi-Chushi therapy showed significant improvement in adequate relief and IBS symptom severity scale; Shugan-Jianpi therapy showed the best efficacy in relieving the abdominal pain and abdominal distension; Wenshen-Jianpi therapy had a better effect on avoiding adverse effects and improving stool character.

This study confirmed that CHM could be beneficial for patients with IBS in relieving their clinical symptoms and should be recommended as alternative therapies. The quality of evidence in this study based on the GRADE system was “low”.

• Abdominal Pain/drug therapy
• Adult
• Databases, Factual
• Drugs, Chinese Herbal/adverse effects
• Humans
• Irritable Bowel Syndrome/drug therapy
• Network Meta-Analysis
• Odds Ratio
• Phytotherapy/methods
• Randomized Controlled Trials as Topic
• Treatment Outcome

• National Natural Science Foundation of China
• construction of Chinese first-class discipline research of key project of Guangzhou University of Chinese Medicine
• construction of Chinese first-class discipline of Guangzhou University of Chinese Medicine
• construction of high-level university of Guangzhou University of Chinese Medicine
• innovation team to foster scientific research projects of Guangzhou University of Chinese Medicine

Irritable bowel syndrome (IBS) is a common recurrent functional gastrointestinal disorder that impacts on patients physically and mentally. Studies on IBS have focused on adults, yet few studies have examined IBS among female university students. The aim of this study was to investigate the prevalence of IBS for female university students and its related factors. Using a cross-sectional study design, a total of 2520 female university students were recruited in southern Taiwan. The structured questionnaires, including the Rome III IBS diagnostic questionnaire, IBS symptom severity scale, Perceived Stress Scale, and World Health Organization Quality of Life BREF questionnaire (WHOQOL-BREF) were used for data collection. A total of 1894 female students complete the questionnaires. The response rate was 75.15%. The results indicated 193 female students with IBS and the prevalence of IBS was 10.1%. IBS female students had higher levels of stress and lower QOL than non-IBS female students. The risk factors for female university students developing IBS were dysmenorrhea, food avoidance, class absenteeism, and the lower physical domain of QOL. It is advised to consider these factors when providing students with counselling and relevant services in the expectation of alleviating their IBS symptoms, reducing the incidence rate of IBS, and further improving their QOL.

• female university students
• irritable bowel syndrome
• prevalence
• quality of life
• stress

• Adult
• Cross-Sectional Studies
• Female
• Humans
• Irritable Bowel Syndrome/epidemiology
• Prevalence
• Quality of Life
• Risk Factors
• Students
• Surveys and Questionnaires
• Taiwan/epidemiology
• Universities

Irritable bowel syndrome (IBS) is a bowel disorder involving abdominal pain or discomfort along with irregularity of stool form and passage frequency. The pathophysiology is poorly understood and seems to be multifactorial. Investigations of possible causes of IBS have included only a few colonic transit studies and no simultaneous determination of the colonic faecal content.

To compare colon transit time and faecal load between IBS-patients and healthy control subjects.

The study included 140 patients with IBS, with a mean age of 50.0 years. The control group comprised 44 healthy persons with a mean age of 43.4 years, who were selected at random from the National Civil Register. Both the patient group and the control group underwent a marker study to measure colon transit time (CTT) and to calculate a faecal loading score. The patient group underwent treatment with a combined prokinetic regime, after which their CTT and faecal loading were reassessed. Analyses were performed to compare measurements between the control group and the patient group before and after treatment.

Compared to healthy controls, IBS-patients exhibited a significantly prolonged mean CTT (45.48 h vs 24.75 h, P = 0.0002) and significantly greater mean faecal loading scores in all colonic segments (P < 0.001). Among IBS patients, we found no significant differences between the 48 h and 96 h radiographs. Among patients exhibiting increased CTT and faecal loading, approximately half exhibited a palpable mass in the right iliac fossa. After intervention with a prokinetic treatment, the mean CTT among IBS patients was reduced from 45.48 h to 34.50 h (P = 0.091), with the post-treatment CTT not significantly differing from the CTT among control subjects (P = 0.095). The faecal loading score among IBS patients did not significantly differ before and after treatment (P = 0.442). The post-treatment faecal loading score in IBS patients remained significantly higher compared to that in controls (5.3 vs 4.3, P = 0.014). After treatment, half of the IBS-patients were relieved of bloating, while the majority no longer experienced abdominal pain and achieved a daily consistent stool.

IBS-patients exhibited prolonged CTT and heavier faecal loading. These assessments may aid in diagnosis. Faecal retention may contribute to IBS symptoms, which can be treated using a prokinetic regime.

• Irritable bowel syndrome
• Functional bowel disease
• Faecal retention
• Colon transit time
• Faecal load

In this study, we aim to evaluate the efficacy and safety of acupoint catgut embedding for the treatment of diarrhea-predominant irritable bowel syndrome and constipation-predominant irritable bowel syndrome. We searched seven online databases to collect studies published up to Feb 29^th, 2020. Study quality of each included article was evaluated by the Cochrane Collaboration Risk of Bias Tool. Systematic reviews and meta-analyses were conducted based on the Cochrane systematic review method by using RevMan 5.3 software. Among the included trials, acupoint catgut embedding alone or plus oral western medicine or plus other acupoint-based therapies, or plus oral traditional Chinese medicine were the main therapies in the experimental groups. Interventions in control groups mainly include oral western medicine alone, other acupoint-based therapies alone, or other acupoint-based therapies alone. Primary outcomes in this study include recovery rate, accumulative marked effective rate, accumulative effective rate, and recurrence rate. Finally, 30 trials involving 1889 participants were included. The results of systematic reviews and meta-analyses show that acupoint catgut embedding alone or plus oral western medicine or plus other acupoint-based therapy or plus oral traditional Chinese medicine was significantly better compared with using oral western medicine alone in terms of efficacy for IBS-C and IBS-D. In addition, acupoint catgut embedding alone or plus oral western medicine or plus other acupoint-based therapy or plus oral traditional Chinese medicine could improve the effective rate and decrease the recurrence rate for IBS-D compared with using oral western medicine, other acupoint-based therapies, or oral traditional Chinese medicine alone. Adverse events of acupoint catgut embedding include local induration, redness, swelling, and itchiness, but they were all mild and disappeared swiftly with ordinary local interventions. There is an urgent need for RCTs of high quality and large sample size and with longer treatment duration and follow-up periods of acupoint catgut embedding for IBS.

The intestinal barrier is a complex and well-controlled physiological construct designed to separate luminal contents from the bowel wall. In this review, we focus on the intestinal barrier’s relationship with the host’s immune system interaction and the external environment, specifically the microbiome. The bowel allows the host to obtain nutrients vital to survival while protecting itself from harmful pathogens, luminal antigens, or other pro-inflammatory factors. Control over barrier function and the luminal milieu is maintained at the biochemical, cellular, and immunological level. However, disruption to this highly regulated environment can cause disease. Recent advances to the field have progressed the mechanistic understanding of compromised intestinal barrier function in the context of gastrointestinal pathology. There are numerous examples where bowel barrier dysfunction and the resulting interaction between the microbiome and the immune system has disease-triggering consequences. The purpose of this review is to summarize the clinical relevance of intestinal barrier dysfunction in common gastrointestinal and related diseases. This may help highlight the importance of restoring barrier function as a therapeutic mechanism of action in gastrointestinal pathology.

• Intestinal barrier
• Microbiome
• Gastrointestinal disease
• Inflammatory bowel disease
• Inflammatory bowel syndrome
• Colitis

• acupuncture
• irritable bowel syndrome
• meta-analysis
• protocol
• tongxieyaofang

• Acupuncture Therapy
• Combined Modality Therapy
• Drugs, Chinese Herbal
• Humans
• Irritable Bowel Syndrome/therapy
• Meta-Analysis as Topic
• Research Design
• Systematic Reviews as Topic

The Trachyspermum ammi L. (TA), Anethum graveolens L. (AG), and Zataria multiflora Boiss (ZM) herbal oils are among the most used herbal products in traditional medicine as the antiseptic, anesthetic, carminative, and antispasmodic. However, there are no clinical studies to evaluate the efficacy of the herbs mentioned in the treatment of functional dyspepsia (FD). This study was designed to appraise the efficacy and safety of a novel herbal medicine consisting of ZM, AG, and TA essential oils compared to omeprazole in FD treatment.

The present study was a randomized double-blind clinical trial with parallel groups in Iran. Patients in control and intervention arms received omeprazole 20 mg once a day and 250 mg soft-gel capsules containing 180 mg of essential oils of ZM, AG, and TA twice a day for two weeks, respectively. The primary outcome was the sufficient response rate in the postprandial distress syndrome (PDS) and/or epigastric pain syndrome (EPS) at the end of the intervention. Secondary outcomes were the improvement rate in the PDS, EPS, Gastrointestinal Symptom Rating Scale (GSRS), and quality of life scores. Also, safety and tolerability were assessed.

The within-group comparison of EPS, PDS, total GSRS, GSRS Pain, and GSRS Dyspepsia scores with that at the end of the treatment indicated a significant reduction in both control and intervention groups (p < 0.001). However, after two weeks of treatment, the herbal medication and omeprazole arms were significantly different in the sufficient response rate based on PDS (p < 0.01) and EPS (p < 0.05) scores (78.3% (18/23) and 73.7% (14/19) in the intervention group vs. 36.4% (8/22) and 40.9% (9/22) in the control group). Also, the mean reduction in EPS (p < 0.05), PDS (p < 0.01), and GSRS (p < 0.001) scores after treatment was significantly higher in the intervention group than control group.

Based on the study findings, this herbal medicine can be considered as an appropriate treatment of FD. However, a larger multicenter trial is needed to confirm the results of the trial.

• Adults
• Clinical practice
• Irritable bowel syndrome
• Network meta-analysis
• Nonpharmacological interventions
• Randomized controlled trials

• Acupuncture Therapy
• Adult
• Humans
• Irritable Bowel Syndrome/diagnosis
• Irritable Bowel Syndrome/therapy
• Randomized Controlled Trials as Topic
• Treatment Outcome

• depression & mood disorders
• functional bowel disorders
• inflammatory bowel disease
• microbiology
• nutritional support

• Adolescent
• Adult
• Canada
• Cohort Studies
• Gastrointestinal Microbiome
• Humans
• Inflammatory Bowel Diseases/epidemiology
• Inflammatory Bowel Diseases/microbiology
• Irritable Bowel Syndrome/epidemiology
• Irritable Bowel Syndrome/microbiology
• Observational Studies as Topic
• Prospective Studies
• Quality of Life
• Young Adult

• RN279389–35803 Canadian Institute of Health Research

• gastroenterology

• Irritable bowel syndrome
• Polycystic ovary syndrome
• Quality of life

• Adult
• Case-Control Studies
• Female
• Healthy Volunteers/psychology
• Humans
• Iran/epidemiology
• Irritable Bowel Syndrome/complications
• Irritable Bowel Syndrome/epidemiology
• Irritable Bowel Syndrome/psychology
• Polycystic Ovary Syndrome/complications
• Polycystic Ovary Syndrome/epidemiology
• Polycystic Ovary Syndrome/psychology
• Prevalence
• Quality of Life/psychology
• Symptom Assessment/statistics & numerical data

• 95135 Hormozgan University of Medical Sciences

Background: Irritable bowel syndrome (IBS) is one of the most common functional diseases of the gastrointestinal tract. A typical symptom is changed bowel patterns: diarrhea, constipation, or alternation of the two. Abdominal pains vary in intensity and location, with periods of exacerbation and remission, causing disorganization in everyday life and work. Educational intervention could be one strategy to improve the well-being of IBS patients. Only a few trials have examined this hypothesis. The aim of this study was to examine the effect of an educational program combined with elements of behavioral therapy, individualized for each patient, on quality of life (QOL) and severity of pain of patients with IBS. Methods: In total, 150 IBS patients and 100 healthy persons in the control group were included. QOL (36-Item Short Form Health Survey, SF-36) and pain severity (Visual Analogue Scale) were measured at baseline and six months after education of IBS patients. Results: At baseline, patients with IBS showed highly significantly worse QOL. In the IBS group, significantly higher physical component summary (PCS) and mental component summary (MCS) scores were noted for 35- to 50-year-old patients compared to other patients. Six months after education and behavioral therapy, significant improvement in QOL and a significant decrease in the subjective perception of pain severity were noted compared to values before therapeutic education. Conclusion: An educational program combined with elements of behavioral therapy, individualized for patients with IBS, is an important part of therapy for these patients.

• education
• irritable bowel syndrome
• quality of life

The unresponsiveness to conventional pharmacological treatments and their side effects have led patients with irritable bowel syndrome (IBS) to use complementary and alternative medicine such as herbal remedies. Beside, Zataria multiflora Boiss (ZM), Trachyspermum ammi L. (TA), and Anethum graveolens L. (AG) are being used as an antiseptic, carminative, and antispasmodic in traditional medicine. This trial investigated the efficacy and safety of a combination of ZM, AG, and TA essential oils in the treatment of IBS.

The present study was a randomized double-blind clinical trial with parallel groups in Iran. Patients in the control arm received three tablets of 10 mg hyoscine butylbromide daily for two weeks, and the intervention arm was daily treated with two 250 mg softgel capsules containing 180 mg of essential oils of ZM, AG, and TA for two weeks. Primary outcomes were the response rates based on the IBS Symptom Severity Scale (IBS-SSS), IBS Adequate Relief (IBS-AR), and IBS Global Assessment Improvement (IBS-GAI) at the end and two weeks after the end of the intervention. Secondary outcomes were the improvement rates in IBS-SSS scores, improving the quality of life, safety, and tolerability.

The posttreatment improvement percentage based on IBS-AR, IBS-GAI, and IBS-SSS scales was 83.9%, 75%, and 87% in the intervention group and 37.9%, 27.5%, and 34.4% in the control group, respectively (P < 0.001). Also, the improvement of the quality of life in the herbal medicine arm was significantly more than that in the control arm (P < 0.001).

According to the results, the herbal medicine investigated in this study can be considered an appropriate alternative treatment for IBS.

• Abdominal pain
• Bloating
• Carbohydrate malabsorption
• Diarrhea
• Irritable bowel syndrome
• Sucrase-isomaltase deficiency

• Antispasmodic agent
• Irritable bowel syndrome
• Phloroglucinol

• gut microbiota
• irritable bowel syndrome
• low FODMAP diet
• nutrition

• Diet, Carbohydrate-Restricted/methods
• Disaccharides/analysis
• Fermentation
• Food Analysis
• Humans
• Irritable Bowel Syndrome/diet therapy
• Monosaccharides/analysis
• Oligosaccharides/analysis
• Polymers/analysis

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder with recurrent abdominal pain and altered defecation habits. We here attempted to determine the effect of acupuncture on IBS.

Randomized controlled trials (RCTs) published in CNKI, VIP, Wanfang, PubMed, Cochrane Library, EMBASE, Web of science, and ClinicalTrials.gov till July 17, 2019 were searched. Outcomes were total efficacy rates, overall IBS symptom scores, or global quality of life scores. Standardized mean difference (SMD) with 95% confidence intervals (CI) and risk ratio (RR) with 95% CI were calculated for meta-analysis.

We included 41 RCTs involving 3440 participants for analysis. 8 RCTs compared acupuncture with sham acupuncture, among which 3 trials confirmed the biological effects of acupuncture, especially in treating abdominal pain, discomfort, and stool frequency. No significant difference was found when acupuncture was compared with sham acupuncture, in terms of effects on IBS symptoms and quality of life (SMD = 0.18, 95% CI −0.26∼0.63, P=0.42; SMD = −0.10, 95% CI −0.31∼0.11, P=0.35), but the pooled efficacy rate data showed a better outcome for true acupuncture (RR = 1.22, 95% CI 1.01∼1.47, P=0.04), which was not supported by sensitivity analysis. Acupuncture was more effective relative to western medicine in alleviating IBS symptoms (RR = 1.17, 95% CI 1.12∼1.23, I² = 0%, P < 0.00001), whose effect might last 3 months. Besides, acupuncture as an adjunct to western medicine, Chinese medications, or tuina was superior over the single latter treatment (RR = 1.68, 95% CI 1.18 to 2.40, P=0.004; 1.19, 1.03 to 1.36, P=0.02; 1.36, 1.08 to 1.72, P=0.009, respectively), with high heterogeneities.

Relative to sham controls, acupuncture showed no superiority for treating IBS, while the advantage over western medicine was significant. Acupuncture could be used as an adjunct in clinical settings to improve efficacy. Future high-quality and large-sample-size studies with adequate quantity-effect design need to be conducted.

Irritable bowel syndrome (IBS) is the most common reason to visit a gastroenterologist. IBS was believed to be a functional disease, but many possible pathophysiologic mechanisms can now explain the symptoms. IBS patients are classified into subtypes according to their predominant bowel habit, based on the Rome IV criteria. These include diarrhea-predominant and constipation-predominant IBS, as well as the mixed type, a combination of the two. Usually, IBS treatment is based on the predominant symptoms, with many options for each subtype. A new promising treatment option, fecal microbiota transplantation, seems to have beneficial effects on IBS. However, treating the pathophysiological causative agent responsible for the symptoms is an emerging approach. Therefore, before the appropriate therapeutic option is chosen for treating IBS, a clinical evaluation of its pathophysiology should be performed.

• Irritable bowel syndrome
• Rome IV criteria
• fecal microbiota transplantation
• pathophysiology
• treatment

Irritable bowel syndrome (IBS) is a lifelong condition with a high prevalence among children and adults. As the diet is a frequent factor that triggers the symptoms, it has been assumed that by avoiding the consumption of fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP), the symptoms might be improved. Therefore, in the past decade, low FODMAP diet has been intensively investigated in the management of IBS. The capacity of FODMAPs to trigger the symptoms in patients with IBS was related to the stimulation of mechanoreceptors in the small and large intestine. This stimulation appears as a response to a combination of increased luminal water (the osmotic effect) and the release of gases (carbon dioxide and hydrogen) due to the fermentation of oligosaccharides and malabsorption of fructose, lactose and polyols. Numerous studies have been published regarding the efficacy of a low FODMAP diet compared to a traditional diet in releasing the IBS symptoms in adults, but there are only a few studies in the juvenile population. The aim of this review is to analyze the current data on both low FODMAP diet in children with IBS and the effects on their nutritional status and physiological development, given the fact that it is a restrictive diet.

• Low fermentable oligosaccharides
• Disaccharides
• Monosaccharides
• Polyols
• Diet
• Children
• Irritable bowel syndrome
• Symptom

Functional bowel disorders (FBD), such as irritable bowel syndrome (IBS), are increasingly more common in children and affect up to 20% of children. The etiology is multifactorial with no clear organic cause. Symptoms are recurrent and are associated with a reduced quality of life, school absences, and psychological challenges. Treatment options are variable. FODMAPs are short‐chained carbohydrates, poorly absorbed by the gastrointestinal tract due to their increased osmotic activity and excess gas production from the bacterial fermentation process. There is a paucity of data examining dietary interventions that restrict carbohydrates in children with IBS. The aim of this study was to examine the use of the low FODMAP diet (LFD) in children with an FBD.

A retrospective clinical case note review of children with an FBD managed with an LFD was undertaken. Anthropometry and clinical data were collected by a pediatric gastroenterology dietitian. An IBS satisfaction survey was used to assess diet outcomes. Statistical analyses were completed using Excel.

Of the 29 children included in this study, complete resolution of gastrointestinal symptoms was observed for 11 of 12 (92%) of those with bloating, 13 of 15 (87%) of those with diarrhea, and 17 of 22 (77%) of those with abdominal pain. Twenty‐three (79%) participants reported an improvement of symptoms. Fructans were the most common symptom‐causing carbohydrate.

The LFD is a useful dietary treatment strategy for children with FBD. This study adds to the small body of evidence supporting FODMAP dietary interventions in children with FBD. Further prospective studies are required.

• dietetics
• functional bowel disorder
• gastroenterology
• nutrition
• pediatrics

• fecal microbiota transplantation
• gastrointestinal microbiome
• irritable bowel syndrome

There is a lack of dietitians trained to deliver the low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet (LFD) for irritable bowel syndrome (IBS). Many patients receive nutritional information from general practitioners (GPs) or gastroenterologists (GEs). Since the LFD is dietitian-led, the aim of this research was to qualitatively explore the effects of GP- and GE-delivered LFD information, in IBS self-management. Semi-structured interviews were conducted in a purposive sample of 8 people with IBS (6 female), who used the LFD as their primary treatment. Interpretive Phenomenological Analysis (IPA) was used to develop themes on the lived experience of the participant’s use of LFD information from GPs and GEs. This information was perceived as trustworthy but simplistic; often just ”food lists” with little personalisation to meet individual needs and difficult to apply in ”real life”. The information required substantial interpretation and the familial and social effects of implementation were not addressed in the materials provided. Supplementary digital resources were regarded as more practical but the participants expressed concern in relation to the validity of these materials. The findings in this study support current clinical guidelines proposed by both the National Institute for Health and Care Excellence and the British Dietetic Association that the LFD should be considered a dietitian-led only intervention.

• education delivery
• irritable bowel syndrome
• low FODMAP diet
• nutritional information

• IBS-C
• abdominal pain
• adverse event
• bloating
• bowel movements
• diarrhea
• linaclotide

• Abdominal Pain/etiology
• Abdominal Pain/prevention & control
• Adult
• Aged
• Constipation/drug therapy
• Female
• Flatulence/etiology
• Flatulence/prevention & control
• Guanylyl Cyclase C Agonists/therapeutic use
• Humans
• Irritable Bowel Syndrome/complications
• Irritable Bowel Syndrome/drug therapy
• Male
• Middle Aged
• Patient Satisfaction
• Peptides/therapeutic use
• Portugal

• Antidepressive Agents/therapeutic use
• Cognitive Behavioral Therapy
• Constipation/drug therapy
• Constipation/etiology
• Diet Therapy/methods
• Exercise
• Gastrointestinal Agents/therapeutic use
• Humans
• Intestines/drug effects
• Irritable Bowel Syndrome/complications
• Irritable Bowel Syndrome/physiopathology
• Irritable Bowel Syndrome/therapy
• Visceral Pain/drug therapy
• Visceral Pain/etiology
• Visceral Pain/physiopathology

• R01 DK092179 NIDDK NIH HHS
• R01 DK115950 NIDDK NIH HHS

• irritable bowel syndrome with diarrhea
• meta-analysis
• protocol
• systematic review
• transcutaneous electric nerve stimulation over acupoints

• Humans
• Acupuncture Points
• Diarrhea/therapy
• Irritable Bowel Syndrome/therapy
• Transcutaneous Electric Nerve Stimulation/methods
• Meta-Analysis as Topic
• Systematic Reviews as Topic

• Abdominal imaging
• Irritable bowel syndrome
• Rome criteria

• DNIC
• Electroacupuncture
• Heterotopic acupoints
• Homotopic acupoints
• IBS

Background: Fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) are an heterogeneous group of compounds that can be poorly digested and may have a range of effects on gastrointestinal processes. FODMAPs are found in a wide variety of foods, including bread. FODMAPs’ intake is associated with the onset of symptoms of irritable bowel syndrome (IBS). On the other hand, some FODMAPs contribute to the healthy maintenance of intestinal microbiota. Volume increase of bread dough commonly relies on the use of two biological leavening agents, sourdough and baker’s yeast and, in some cases, a combination of both.

Scope and Approach: The main objective of this review is to discuss the association between FODMAPs and IBS, beneficial effects of FODMAPs on healthy subjects and potential impact of biological leavening agents on FODMAPs content of bread.

Key Findings and Conclusion: Given that yeasts and lactic acid bacteria, the dominant microorganisms in sourdough, may degrade FODMAPs, it would be possible to modulate the FODMAPs concentration in bread, thus positively affecting consumers’ health.

• bread
• disaccharides
• fermentable oligosaccharides
• irritable bowel syndrome
• lactic acid bacteria
• monosaccharides and polyols
• sourdough
• yeasts

• IBS
• controlled studies
• depressive symptoms
• meta-analysis

• Cross-Sectional Studies
• Depression/physiopathology
• Depression/psychology
• Female
• Humans
• Irritable Bowel Syndrome/physiopathology
• Irritable Bowel Syndrome/psychology
• Male
• Quality of Life

• Chinese medicine
• Diarrhea-predominant
• Indication
• Irritable bowel syndrome
• Prediction of the treatment outcome
• Randomized controlled trial
• Tiao-Chang Ke-Min granules