Abstract. The time course of development of polarity of an apical (184-kD) and a basolateral (63-kD) plasma membrane protein of Madin-Darby canine kidney cells was followed using semiquantitative immunofluorescence on semithin (,,o0.5-gm) frozen sections and monoclonal antibody probes. The 184-kD protein became highly polarized to the apical pole within the initial 24 h both in normal medium and in 1-5 IxM Ca 2÷, which results in well-spread, dome-shaped cells, lacking tight junctions and other lateral membrane interactions. In contrast, the basolateral 63-kD membrane protein developed full polarity only after incubation in normal Ca 2+ concentrations for >72 h, a time much longer than that required for the formation of tight junctions (,,o18 h) and failed to polarize in 1-5 IxM Ca 2+. These results demonstrate that intradomain restriction mechanisms independent of tight junctions, such as self-aggregation or specific interactions with the submembrane cytoskeleton, participate in the regionalization of at least some epithelial plasma membrane proteins. The full operation of these mechanisms depends on the presence of normal cell-cell interactions in the case of the basolateral 63-kD antigen but not in the case of the apical 184-kD protein. SECRETORY and transporting epithelia carry out a variety of vectorial functions that depend on the polarization of the plasma membrane into apical and basolateral domains (52, 59). Tight or occluding junctions, located at the boundary between basolateral and apical regions (16,20), confer on the cell layer the property of a selective barrier to the diffusion of ions and macromolecules (42) and appear to play a role in keeping molecules from both domains segregated (10). Recent work has shown that tight junctions constitute a fence for the movement of lipids in the outer leaflet in the bilayer but not for those in the inner leaflet (11,68).A passive fence, however, can maintain but not generate polarity. Other mechanisms have to be postulated to perform this task. In confluent monolayers, with well-developed apical and basolateral poles separated by fight junctions, intracellular sorting mechanisms operating at the level of the Golgi apparatus, have been shown to participate in a vectorial delivery of apical and basolateral proteins to the respective surface domain (4, 37, 39, 46, 51). However, epithelial cells can also generate their surface polarity (and therefore their apical and basal poles) de novo. A typical example in vitro is the passage from a round cell suspension to an asymmetric monolayer after trypsinization and replating (6). There are also examples in vivo; perhaps the most striking is the generation of tubule cells from mesenchymal cells during kidney development (15). It is clear that specific cell-substrate and cell-cell interactions must play a crucial role in these cases. In fact, a previous study has shown that junction-free subconfluent epithelial cells, attached to a collagen substrate, can sustain asymmetric virus budding, a polarity property of confluen...

Abstract. Diet is important in triggering the symptoms of irritable bowel syndrome (IBS). This study investigated the impact of dietary guidance on the symptoms, quality of life and habitual diet of patients with IBS. Forty-six patients who included. Of these patients, 17 completed the entire study. Each patient attended three sessions (~45 min in duration) and received individual guidance on their dietary management. The patients were asked to complete the following questionnaires prior to receiving the dietary guidance, and at least 3 months subsequently: The Birmingham IBS symptom score questionnaire, the IBS Quality of Life (IBS-QOL) questionnaire, the Short-Form Nepean and Dyspepsia Index (SF-NDI) and the MoBa Food Frequency Questionnaire (MoBa FFQ). The time at which patients completed the questionnaires following dietary guidance ranged from 3-9 months (median, 4 months). The total IBS symptom scores were reduced once the patients had received dietary guidance (P=0.001). The total score for the quality of life, as assessed by the IBS-QOL guidance sessions (P=0.003 and P=0.002, respectively). There were no statistical differences in the intake of calories, IBS following dietary guidance. There were increases in the consumption of dairy products, -carotene, retinol equivalents, 12 and calcium, although only the increase in vitamin B 12 and vegetables that were rich in highly fermentable short-chain carbohydrates, disaccharides, monosaccharides and polyols, as guidance sessions, administered by a nurse, reduced the symptoms and improved the quality of life of patients with IBS, and resulted in an adequate intake of vitamins and minerals. Individual dietary guidance is a cost-effective option for the management of IBS. IntroductionIrritable bowel syndrome (IBS) is a chronic functional bowel disorder characterized by a combination of symptoms that have a considerable impact on the patient's quality of life. These symptoms include abdominal pain or discomfort and altered bowel habits (1,2). IBS is more common in females than in males, and is diagnosed more frequently in patients under the age of 50 (1). The prevalence of IBS has been calculated to range from 5-15% of the population worldwide, as determined by diagnostic criteria, such as the Rome criteria (1-14).Approximately two-thirds of patients with IBS consider their symptoms to be related to their diet (15) and therefore restrict their intake of certain dietary agents that they perceive to be provocative. The most commonly reported triggers are carbohydrates and fatty foods, milk and dairy products, wheat products, caffeine, hot spices, certain meats, cabbage, onions, peas, beans and fried and smoked foods (16)(17)(18)(19). Despite these reported effects, numerous studies have demonstrated that dietary composition does not markedly differ between patients with IBS and controls (15-21), although patients with IBS appear to have a low intake of calcium, potassium, magnesium, vitamin A, vitamin B 12 In a previous study by our group, dietary guidance admini...

Irritable bowel syndrome (IBS) is a common chronic disorder with a prevalence ranging from 5 to 10 percent of the world's population. This condition is characterised by abdominal discomfort or pain, altered bowel habits, and often bloating and abdominal distension. IBS reduces quality of life in the same degree of impairment as major chronic diseases such as congestive heart failure and diabetes and the economic burden on the health care system and society is high. Abnormalities have been reported in the neuroendocrine peptides/amines of the stomach, small- and large intestine in patients with IBS. These abnormalities would cause disturbances in digestion, gastrointestinal motility and visceral hypersensitivity, which have been reported in patients with IBS. These abnormalities seem to contribute to the symptom development and appear to play a central role in the pathogenesis of IBS. Neuroendocrine peptides/amines are potential tools in the treatment and diagnosis of IBS. In particular, the cell density of duodenal chromogranin A expressing cells appears to be a good histopathological marker for the diagnosis of IBS with high sensitivity and specificity.

Irritable bowel syndrome (IBS) is a common chronic gastrointestinal disorder. It is widely believed that IBS is caused by a deficient intake of dietary fiber, and most physicians recommend that patients with IBS increase their intake of dietary fiber in order to relieve their symptoms. However, different types of dietary fiber exhibit marked differences in physical and chemical properties, and the associated health benefits are specific for each fiber type. Short-chain soluble and highly fermentable dietary fiber, such as oligosaccharides results in rapid gas production that can cause abdominal pain/discomfort, abdominal bloating/distension and flatulence in patients with IBS. By contrast, long-chain, intermediate viscous, soluble and moderately fermentable dietary fiber, such as psyllium results in a low gas production and the absence of the symptoms related to excessive gas production. The effects of type of fiber have been documented in the management of IBS, and it is known to improve the overall symptoms in patients with IBS. Dietary fiber acts on the gastrointestinal tract through several mechanisms, including increased fecal mass with mechanical stimulation/irritation of the colonic mucosa with increasing secretion and peristalsis, and the actions of fermentation byproducts, particularly short-chain fatty acids, on the intestinal microbiota, immune system and the neuroendocrine system of the gastrointestinal tract. Fiber supplementation, particularly psyllium, is both safe and effective in improving IBS symptoms globally. Dietary fiber also has other health benefits, such as lowering blood cholesterol levels, improving glycemic control and body weight management.

Abstract. The present study investigated the diet and quality of life of irritable bowel syndrome (IBS) patients in comparison to the background population. Furthermore, it studied the effects of guidance on diet management on changes in food intake, quality of life and symptoms. A total of 35 healthy controls, 36 IBS patients and 43 IBS patients who had received guidance on diet management 2 years earlier were included. The controls and patients were asked to complete an FFQ questionnaire, an SF-NDI questionnaire, an IBS-QoL questionnaire and a Birmingham IBS symptom score questionnaire. There were no statistical differences in the intake of calories, carbohydrates, proteins and fat between the controls and IBS patients, with or without guidance on diet management. IBS patients made a conscious choice to avoid certain food items, some of which belong to fermentable oligosaccharides, disaccharides, monosacharides and polyols (FODMAPs). They had a higher consumption, however, of other food items that are rich in FODMAPs. They also avoided other food sources which are crucial for their health. Two years after receiving guidance on diet management, IBS patients had a different diet profile. They avoided all FODMAP-rich food, consumed more food with probiotic supplements and did not avoid food sources that were crucial to their health. In addition, they had improved quality of life and reduced symptoms. Although at first sight the diet of IBS patients did not differ from that of the background population, detailed examination showed avoidance of certain food items. Guidance on the management of diet improved their choice of a healthier diet, improved quality of life and reduced IBS symptoms. IntroductionIrritable bowel syndrome (IBS) is a chronic gastrointestinal disorder in absence of any structural, physiological or biochemical abnormalities in the gastrointestinal tract (1). The condition is classified as a functional disorder for which the diagnosis is based on the presentation of symptoms. These symptoms are abdominal discomfort or pain, bloating and abdominal distension, and changes in bowel habit between diarrhoea and constipation (1). The degree of symptoms varies in different patients from tolerable to severe, where the experience of pain may vary from a nagging, colicky, sharp or dull feeling of pain. Also, the time pattern and discomfort varies immensely from patient to patient (2-14). Some complain of daily symptoms, while others report intermittent pain at intervals of weeks/months. The supportive symptoms mentioned above may also be used to subclassify IBS patients into three subtypes: diarrhoea-predominant (IBS-D), constipationpredominant (IBS-C) and alternating constipation/diarrhea (IBS-M) (2-4).The estimated prevalence of IBS varies from 12 to 30%; this large variation is explained by the use of different definitions in different studies (15). A cross-sectional population-based survey conducted in Oppland and Hedmark County in Norway using recent diagnostic criteria estimated the prevalence to affe...