Changes in duodenal enteroendocrine cells in patients with irritable bowel syndrome following dietary guidance

Abstract

Several contributing factors to the symptomology of irritable bowel syndrome (IBS) have been identified, such as abnormal densities of enteroendocrine cells and diet; however, the interactions between these factors have not been studied yet. The current study aims at exploring the dynamic changes between these two factors by studying the effect of using low fermentable oligo-, di-, monosaccharides and polyol (FODMAP) diet (known to improve IBS symptoms) through dietary guidance on the enteroendocrine cell densities in the duodenum. The findings showed that the densities of different enteroendocrine cells in the duodenum were abnormal before the patients received dietary guidance and tend to change/normalize after receiving guidance, which may have contributed in improving the symptoms of IBS. These findings highlight the importance of enteroendocrine cells in IBS pathophysiology and the mechanism behind the positive effect of low FODMAP dietary guidance in improving IBS symptoms and its usage as first step in the line of IBS management. AbstractThe densities of enteroendocrine cells are abnormal in patients with irritable bowel syndrome (IBS); however, they tend to change toward normal levels in stomach, ileum, and colon following dietary guidance. The aim was to identify the types of duodenal enteroendocrine cells affected after receiving dietary guidance in the same group of patients with IBS. Fourteen patients with IBS and 14 control subjects were included. The patients received three sessions of dietary guidance. Both groups underwent gastroscopies at baseline, and again for the patients after 3-9 months (median, four months) from receiving dietary guidance. Tissue biopsies were collected from the descending part of the duodenum and were immunostained for all the types of enteroendocrine cells and were then quantified by using computerized image analysis. Using the Kruskal-Wallis non-parametric test with Dunn's test as a post-test, the results showed a significant difference in the secretin cell densities between control subjects and patients with IBS prior to and following dietary guidance (P ¼ 0.0001 and 0.011, respectively). The corresponding P values for cholecystokinin (CCK) cell densities were 0.03 and 0.42, respectively; gastric inhibitory peptide (GIP) cell densities were 0.06 and 0.43, respectively; serotonin cell densities were <0.0001 and 0.002, respectively; and for somatostatin cell densities were <0.0001 and 0.052, respectively. The Paired t-test showed a significant difference only in the serotonin (P ¼ 0.03) and somatostatin (P < 0.0001) cell densities between IBS patients prior to and following dietary guidance. The changes in the cell densities of secretin, CCK, and GIP were not significant between IBS patients prior to and following dietary guidance. In conclusion, the densities of several duodenal enteroendocrine cells in IBS patients changed toward the values measured in control subjects following dietary guidance. The changes in serotonin and somatostatin cell densities may have contrib...

Effect of diet and individual dietary guidance on gastrointestinal endocrine cells in patients with irritable bowel syndrome (Review)

“…At the cellular level, changing the diet through individual dietary guidance changes the densities of different GI endocrine cells in different parts of the GI tract ( 172 – 175 ), as shown in Figs. 2 – 5 .…”

“…For example, in the stomach, the densities of several endocrine cells (gastrin, ghrelin, serotonin and somatostatin) changed toward the values measured in healthy control subjects after providing dietary guidance, but only somatostatin cell density showed a significant change in the gastric corpus ( 181 ). The densities of serotonin cells in the duodenum and ileum changed significantly ( 172 , 175 ), and the density of somatostatin cells in the duodenum changed significantly after providing dietary guidance toward that measured in healthy control subjects ( 175 ). After providing dietary guidance, the densities of serotonin and PYY cells tend to normalize in different segments of the colon, with the density of somatostatin cells increasing in the rectum ( 174 ).…”

Abnormal Uroguanylin Immunoreactive Cells Density in the Duodenum of Patients with Diarrhea-Predominant Irritable Bowel Syndrome Changes following Fecal Microbiota Transplantation

“…Interactions of the above-mentioned contributing factors with each other have certain effects on the gut-brain axis that may contribute to the development of symptoms related to the gastrointestinal [9,10] and nervous [11,12] systems. Previous publications have shown the effect of dietary changes on the symptoms [1,[13][14][15][16], gut microbiota [17,18], and enteroendocrine cells [19][20][21] in IBS patients. In addition, changing the composition of the gut microbiota through fecal microbiota transplantation (FMT) had a positive clinical outcome not only in cases of Clostridium difficile [22,23] but also in IBS [24][25][26][27][28].…”

Expression of serotonin, somatostatin, and glucagon-like peptide 1 (GLP1) in the intestinal neuroendocrine cells of pigs fed with population rye type and hybrid rye type grains

“…3. Single somatostatin-immunoreactive NEC found in the small intestine of control (C2) and experimental (HR group) animals by dietary guidance (24). In rats with experimentally induced colitis, the numbers of somatostatin-IR NEC were significantly lower than they were in the controls (12).…”

“…Additionally, it has also been demonstrated that increased numbers of serotonin NEC in the small intestine mucosae accompany several gastrointestinal disorders, such as celiac disease (25), refractory celiac disease (9), and inflammatory bowel disease (32). In the course of inflammatory bowel disease, a proper diet can change the number of NEC to normal (24). It is known that the main action of intestinal serotonin is to promote local inflammation.…”