Prevalence of Fructose Malabsorption in Patients With Irritable Bowel Syndrome After Excluding Small Intestinal Bacterial Overgrowth

Jung, Kee Wook; Seo, Myeognsook; Cho, Young Hwan; Park, Young-Ok; Yoon, So-Yoon; Lee, Jung Bok; Yang, Dan; Yoon, In Ja; Seo, So Young; Lee, Hyo‐Jeong; Park, Sang Hyoung; Kim, Kyung Jo; Ye, Byong Duk; Jung, Hwoon‐Yong; Yang, Suk‐Kyun; Kim, Jin-Ho; Myung, Seung‐Jae

doi:10.5056/jnm17044

Cited by 19 publications

(20 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Malabsorption, in particular fructose malabsorption, has been shown to be associated with IBS ( 49 , 50 ). Our study population is representative in that regard as 53% of IBS patients had concurrent fructose malabsorption diagnosed prior to evaluation for IBS.…”

Section: Discussionmentioning

confidence: 99%

The Role of Brain-Derived Neurotrophic Factor in Irritable Bowel Syndrome

et al. 2021

View full text Add to dashboard Cite

Several studies have implied a role of brain-derived neurotrophic factor (BDNF) in abdominal pain modulation in irritable bowel syndrome (IBS). The aim of this study was to establish BDNF protein expression in human colonic biopsies and to show variation in IBS compared to controls. BDNF protein and mRNA levels were correlated with IBS symptom severity based on the IBS-symptom severity score (IBS-SSS). Biopsies from the descending colon and IBS-SSS were obtained from 10 controls and 20 IBS patients. Total protein of biopsies was extracted and assessed by ELISA and Western Blot. Total mRNA was extracted and gene expression measured by nCounter analysis. In IBS patients, symptom severity scores ranged from 124 to 486 (mean ± sem: 314.2 ± 21.2, >300 represents severe IBS) while controls ranged from 0 to 72 (mean ± sem: 27.7 ± 9.0, <75 represents healthy subjects, p < 0.001). IBS patients reported significantly more food malabsorption, former abdominal surgery and psychiatric comorbidities. BDNF protein was present in all samples and did not differ between IBS and controls or sex. Subgroup analysis showed that female IBS patients expressed significantly more BDNF mRNA compared to male patients (p < 0.05) and male IBS-D patients had higher IBS symptom severity scores and lower BDNF mRNA and protein levels compared to male controls (p < 0.05). Scatter plot showed a significant negative correlation between IBS-SSS and BDNF mRNA levels in the cohort of male IBS-D patients and their male controls (p < 0.05). We detected a high proportion of gastrointestinal surgery in IBS patients and confirmed food intolerances and psychiatric diseases as common comorbidities. Although in a small sample, we demonstrated that BDNF is detectable in human descending colon, with higher BDNF mRNA levels in female IBS patients compared to males and lower mRNA and protein levels in male IBS-D patients compared to male controls. Further research should be directed toward subgroups of IBS since their etiologies might be different.

show abstract

Section: Discussionmentioning

confidence: 99%

The Role of Brain-Derived Neurotrophic Factor in Irritable Bowel Syndrome

et al. 2021

View full text Add to dashboard Cite

show abstract

“…140 Therefore, dietary management is recommended as an important part of the treatment of IBS. [141][142][143] In a study conducted to investigate food groups and specific food items that cause GI symptoms in IBS patients, women tended to report more food items that cause symptoms than men. 144 Increased fiber and fish intake, decreased fatty meal intake, reduced sweets, red meat, and reduced coffee and alcohol intake were all significantly different between the case and control groups of women.…”

Section: Dietmentioning

confidence: 99%

Sex-Gender Differences in Irritable Bowel Syndrome

Kim

2018

J Neurogastroenterol Motil

188

133

View full text Add to dashboard Cite

Because of the sex-gender differences that are shown in a diversity of physiological and psychological factors, it can be speculated that the clinical presentation of symptoms as well as treatment strategies in women and men with irritable bowel syndrome (IBS) may differ. Studies have revealed that IBS is more common in women than men. As for the IBS subtype, IBS with constipation is significantly more prevalent among women than men. Sex hormones and gender differences may play important roles in the pathophysiology of IBS. However, its pathophysiologic mechanisms still remain largely unknown, and therapeutic implications are limited. Moreover, women IBS patients have been reported to feel more fatigue, depression, anxiety, and lower quality of life than men IBS patients. Furthermore, there has been evidence of differences in the appropriate treatment efficacy to IBS in men and women, although relatively few men are enrolled in most relevant clinical trials. A more sex-gender-oriented approach in the medical care setting could improve understanding of heterogeneous patients suffering from IBS. An individualized and multicomponent approach including sex and gender issues might help improve the treatment of IBS.

show abstract

“…According to the North American Consensus (72) , the prevalence of fructose malabsorption in IBS patients is 22 % (76) , which is higher than in healthy individuals (75) . Indeed, after 15, 25, 35 and 50 g fructose loads, breath tests were positive in 20, 22, 45 and 64 % of IBS patients, respectively (Table 1) (76)(77)(78)(79) . Surprisingly, fructose malabsorption prevalence is independent of the IBS subtype (diarrhoea, constipation or mixed) (76) .…”

Section: Fructose Malabsorptionmentioning

confidence: 99%

Fructose and irritable bowel syndrome

et al. 2020

View full text Add to dashboard Cite

Irritable bowel syndrome (IBS) is a chronic disorder characterised by recurrent abdominal pain or discomfort and transit disturbances with heterogeneous pathophysiological mechanisms. The link between food and gastrointestinal (GI) symptoms is often reported by patients with IBS and the role of fructose has recently been highlighted. Fructose malabsorption can easily be assessed by hydrogen and/or methane breath test in response to 25 g fructose; and its prevalence is about 22 % in patients with IBS. The mechanism of fructose-related symptoms is incompletely understood. Osmotic load, fermentation and visceral hypersensitivity are likely to participate in GI symptoms in the IBS population and may be triggered or worsened by fructose. A low-fructose diet could be integrated in the overall treatment strategy, but its role and implication in the improvement of IBS symptoms should be evaluated. In the present review, we discuss fructose malabsorption in adult patients with IBS and the interest of a low-fructose diet in order to underline the important role of fructose in IBS.

show abstract

Prevalence of Fructose Malabsorption in Patients With Irritable Bowel Syndrome After Excluding Small Intestinal Bacterial Overgrowth

Cited by 19 publications

References 29 publications

The Role of Brain-Derived Neurotrophic Factor in Irritable Bowel Syndrome

The Role of Brain-Derived Neurotrophic Factor in Irritable Bowel Syndrome

Sex-Gender Differences in Irritable Bowel Syndrome

Fructose and irritable bowel syndrome

Contact Info

Product

Resources

About