Irritable bowel syndrome: an integrated explanatory model for clinical practice

Hungin, A. P. S.; Becher, Anja; Cayley, B.; Heidelbaugh, Joel J.; Muris, Jean; Rubin, Greg; Seifert, Bohumil; Russell, Alexandra; Wit, Niek J. de

doi:10.1111/nmo.12524

Cited by 26 publications

(28 citation statements)

References 130 publications

(276 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Treatment concepts that target these psychosocial factors of patients with IBS should be based on evidence-based models that take the following three components into account: altered peripheral regulation of gut function, altered brain–gut signalling and reducing psychological distress, including general hypervigilance and a general mindset of catastrophizing 209 . Such models might be helpful as a basis of patient education and a target for effective treatments.…”

Section: Managementmentioning

confidence: 99%

Irritable bowel syndrome

Enck¹,

Aziz

Barbara

et al. 2016

Nat Rev Dis Primers

761

774

View full text Add to dashboard Cite

Irritable bowel syndrome (IBS) is a functional gastrointestinal disease with a high population prevalence. The disorder can be debilitating in some patients, whereas others may have mild or moderate symptoms. The most important single risk factors are female sex, younger age and preceding gastrointestinal infections. Clinical symptoms of IBS include abdominal pain or discomfort, stool irregularities and bloating, as well as other somatic, visceral and psychiatric comorbidities. Currently, the diagnosis of IBS is based on symptoms and the exclusion of other organic diseases, and therapy includes drug treatment of the predominant symptoms, nutrition and psychotherapy. Although the underlying pathogenesis is far from understood, aetiological factors include increased epithelial hyperpermeability, dysbiosis, inflammation, visceral hypersensitivity, epigenetics and genetics, and altered brain–gut interactions. IBS considerably affects quality of life and imposes a profound burden on patients, physicians and the health-care system. The past decade has seen remarkable progress in our understanding of functional bowel disorders such as IBS that will be summarized in this Primer.

show abstract

Section: Managementmentioning

confidence: 99%

Irritable bowel syndrome

Enck¹,

Aziz

Barbara

et al. 2016

Nat Rev Dis Primers

761

774

View full text Add to dashboard Cite

show abstract

“…This signal pathway leads to the augmentation symptomatic response in patients with IBS. A recent study suggested that intestinal microbiota and psychological distress at work were mediators of visceral hypersensitivity [9]. Based on these findings, there have been many attempts to improve IBS symptoms by the manipulation of intestinal microbiota.…”

Section: Introductionmentioning

confidence: 99%

Bifidobacterium-Rich Fecal Donor May Be a Positive Predictor for Successful Fecal Microbiota Transplantation in Patients with Irritable Bowel Syndrome

Mizuno

Masaoka²,

Naganuma³

et al. 2017

Digestion

284

110

View full text Add to dashboard Cite

Background/Aims: Dysbiosis is associated with various systemic disorders including irritable bowel syndrome (IBS). Fecal microbiota transplantation (FMT) might restore intestinal microbial balance. The study aimed to determine the safety and efficacy of FMT in IBS patients, as well as also positive predictors for FMT. Methods: This was a single-arm, open-label study. Eligible patients were diagnosed based on Rome III Diagnostic Criteria. Fecal materials were administered to the patient via colonoscopy. The primary end point was a change in the Bristol stool form scale at 4 weeks after FMT. Recovery to types 3-4 was considered a clinical response. The secondary end point was a change in intestinal microbiota and psychological status using the Hamilton Rating Scale. Results: Ten patients were enrolled. Six patients achieved a clinical response. The diversity of patients 4 weeks after FMT increased significantly compared with patients before FMT, and that of responding patients was significantly higher than non-responder patients. The abundance of Bifidobacterium in effective donors was significantly higher than in ineffective donors and patients. Psychological status of all patients was significantly improved after FMT. Conclusions: FMT for patients with IBS is safe, and relatively effective. Bifidobacterium-rich fecal donor may be a positive predictor for successful FMT. Key Summary: (1) Dysbiosis is associated with various gastrointestinal disorders including IBS. (2) FMT has potential to restore intestinal microbial balance. (3) We showed that FMT improved stool form and psychological status of IBS patients. (4) Bifidobacterium-rich donor efficiently induced symbiosis in IBS patients.

show abstract

“…There are three main hypotheses behind the integrated explanatory model of IBS for clinical practice: altered peripheral regulation of gut function, altered brain gut signaling, and psychological distress. 34…”

Section: Pathogenesis and Pathophysiology Of Ibsmentioning

confidence: 99%

“…An altered peripheral regulation of gut function is triggered by changes in neurotransmitter signaling, GI inflammation, and GI microbial changes. 34 Specific peripheral mechanisms can result in symptoms of IBS. These mechanisms include: abnormal colonic transit and rectal evacuation, intraluminal irritants, inflammation, altered bile acid synthesis, and alterations in the GI microbiome.…”

Section: Altered Peripheral Regulation Of Gut Functionmentioning

confidence: 99%

Evaluation of Nutritional Adequacy and Symptom Improvement During Implementation of the Low-FODMAP Diet in Individuals with Irritable Bowel Syndrome

Richards

Al-Muhanna

Roberts

et al. 2018

Journal of the Academy of Nutrition and Dietetics

View full text Add to dashboard Cite

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder (FGID) that affects 10-20% of adults and adolescents worldwide. A connection has been identified between the consumption of some foods and an exacerbation of IBS symptoms. One nutrition therapy option for IBS is the low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet. A lack of data describing the mechanism of action of this dietary pattern has led to insufficient evidence to establish standard clinical guidelines regarding the use of the low-FODMAP diet in IBS. This study aims to define the duration of the low-FODMAP diet elimination phase for optimal symptom relief and the nutritional adequacy of the low-FODMAP diet. Seventy patients with IBS attended low-FODMAP diet group education classes that were provided monthly, and those who consented to the study were instructed to follow the low-FODMAP diet for six weeks. Subjects completed an IBS-Symptom Severity Scale questionnaire (IBS-SSS) at baseline and at weeks 2, 4, and 6. Subjects completed a three-day diet record at baseline and week 2. Dietary compliance was assessed through daily high-FODMAP food checklists. A total of 35 participants enrolled in this study. Complete data was available for 14 (40%) participants. Incomplete data was available for 2 (6%) participants, and 19 (54%) dropped out of the study. Forty-three percent of the original participants (15/35

show abstract

Irritable bowel syndrome: an integrated explanatory model for clinical practice

Abstract: It was possible to elucidate an integrated, three-component EM as a basis for clinicians to conceptualize the nature of IBS, with the potential to contribute to better diagnosis and management, and dialog with sufferers.

Cited by 26 publications

References 130 publications

Irritable bowel syndrome

Irritable bowel syndrome

Bifidobacterium-Rich Fecal Donor May Be a Positive Predictor for Successful Fecal Microbiota Transplantation in Patients with Irritable Bowel Syndrome

Evaluation of Nutritional Adequacy and Symptom Improvement During Implementation of the Low-FODMAP Diet in Individuals with Irritable Bowel Syndrome

Contact Info

Product

Resources

About