The role of psychological and biological factors in postinfective gut dysfunction Reply

Ledochowski, Maximilian

doi:10.1136/gut.46.1.140a

Cited by 4 publications

(5 citation statements)

References 2 publications

(2 reference statements)

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“…Patients with fructose malabsorption often have a clear history of postinfective onset of their symptoms (19) as has been shown for patients with irritable bowel syndrome (20). However, during the pre-intervention period it was confirmed that all subjects were free of infectious symptoms.…”

Section: Discussionmentioning

confidence: 77%

Fructose- and Sorbitol-reduced Diet Improves Mood and Gastrointestinal Disturbances in Fructose Malabsorbers

Ledochowski

Widner²,

Bair³

et al. 2000

Scandinavian Journal of Gastroenterology

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-and sorbitol-reduced diet improves mood and gastrointestinal disturbances in fructose malabsorbers. Scand J Gastroenterol 2000; 35:1048-1052.Background: Fructose malabsorption is characterized by the inability to absorb fructose efficiently. As a consequence fructose reaches the colon where it is broken down by bacteria to short fatty acids, CO 2 and H 2 . Bloating, cramps, osmotic diarrhea and other symptoms of irritable bowel syndrome are the consequences and can be seen in about 50% of fructose malabsorbers. We have previously shown that fructose malabsorption is associated with early signs of mental depression and low serum tryptophan concentrations. It was therefore of interest whether a fructose-reduced diet could not only improve gastrointestinal complaints but also depressive signs seen in fructose malabsorbers. Methods: Fifty-three adults (12 males, 41 females), who were identified as fructose malabsorbers according to their breath-H 2 concentrations, filled out a Beck's depression inventory-questionnaire, and a questionnaire with arbitrary scales for measurement of meteorism, stool frequency and quality of life for a 4-week period before dietary intervention and 4 weeks after dietary change as for fructose-and sorbitol-reduced diet. Results: Depression scores were reduced by 65.2% after 4 weeks of diet (P`0.0001), and there was a significant reduction of meteorism (P`0.0001) and stool frequency (P`0.01). Improvement of signs of depression and of meteorism was more pronounced in females than in males. Conclusion: Fructose-and sorbitolreduced diet in subjects with fructose malabsorption does not only reduce gastrointestinal symptoms but also improves mood and early signs of depression.

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Section: Discussionmentioning

confidence: 77%

Fructose- and Sorbitol-reduced Diet Improves Mood and Gastrointestinal Disturbances in Fructose Malabsorbers

Ledochowski

Widner²,

Bair³

et al. 2000

Scandinavian Journal of Gastroenterology

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“…Its levels are reduced because of undernutrition,17 malabsorption,3,32 or any significant illness or injury which upregulates KP catabolism 1…”

Section: Protein Energy Malnutrition (Pem) Niacin and Cofactorsmentioning

confidence: 99%

“…Reduced levels of B-12 have a negative impact on certain aspects of tryptophan function 17. The gastric achlor-hydria interferes with the gastrointestinal bacterial balance, which then creates a propensity to secondary infection 32,60,61. Defective substrate production, such as NK and T cells62 reduces effective KP immunological function.…”

Section: Cfs/fm—the Metabolic Enigmamentioning

confidence: 99%

“…Deficiencies in both tryptophan and nicotinamide produce symptoms of pellagra and inadequate supplies of tryptophan can make the patient vulnerable to the development of PEM. Its levels are reduced because of undernutrition, 17 malabsorption, 3,32 or any significant illness or injury which upregulates KP catabolism. 1…”

Section: Protein Energy Malnutrition (Pem) Niacin and Cofactorsmentioning

confidence: 99%

“…Tryptophan 32 and Vitamin B-12 deficiencies are associated with malabsorption and contribute to the causes of nutritional demyelinating disorders. 3 Both substances have juvenile forms of illnesses.…”

Section: Cfs/fm–-the Metabolic Enigmamentioning

confidence: 99%

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Article Commentary: Kynurenine Pathway Pathologies: Do Nicotinamide and Other Pathway Co-Factors have a Therapeutic Role in Reduction of Symptom Severity, Including Chronic Fatigue Syndrome (CFS) and Fibromyalgia (FM)

Blankfield¹

2013

Int J�Tryptophan�Res

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The definition of dual tryptophan pathways has increased the understanding of the mind-body, body-mind dichotomy. The serotonergic pathway highlights the primary (endogenous) psychiatric disorders. The up-regulation of the kynurenine pathway by physical illnesses can cause neuropathic and immunological disorders1 associated with secondary neuropsychiatric symptoms.Tryptophan and nicotinamide deficiencies fall within the protein energy malnutrition (PEM) spectrum. They can arise if the kynurenine pathway is stressed by primary or secondary inflammatory conditions and the consequent imbalance of available catabolic/anabolic substrates may adversely influence convalescent phase efficiency. The replacement of depleted or reduced NAD+ levels and other cofactors can perhaps improve the clinical management of these disorders.Chronic fatigue syndrome (CFS) and fibromyalgia (FM) appear to meet the criteria of a tryptophan-kynurenine pathway disorder with potential neuroimmunological sequelae. Aspects of some of the putative precipitating factors have been previously outlined.2,3 An analysis of the areas of metabolic dysfunction will focus on future directions for research and management.

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Chang’an II Decoction (肠安 II 号方)-Containing Serum Ameliorates Tumor Necrosis Factor-α-Induced Intestinal Epithelial Barrier Dysfunction via MLCK-MLC Signaling Pathway in Rats

Chen

Yin

Kang

et al. 2019

Chin. J. Integr. Med.

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The role of psychological and biological factors in postinfective gut dysfunction Reply

Abstract: Epidemiology supports oral contraceptives as a risk factor in Crohn's disease EDITOR,-A recent clinical alert (Gut 1999;44:311-12) commented on a study of risk factors for relapse in Crohn's disease.

Cited by 4 publications

References 2 publications

Fructose- and Sorbitol-reduced Diet Improves Mood and Gastrointestinal Disturbances in Fructose Malabsorbers

Fructose- and Sorbitol-reduced Diet Improves Mood and Gastrointestinal Disturbances in Fructose Malabsorbers

Article Commentary: Kynurenine Pathway Pathologies: Do Nicotinamide and Other Pathway Co-Factors have a Therapeutic Role in Reduction of Symptom Severity, Including Chronic Fatigue Syndrome (CFS) and Fibromyalgia (FM)

Chang’an II Decoction (肠安 II 号方)-Containing Serum Ameliorates Tumor Necrosis Factor-α-Induced Intestinal Epithelial Barrier Dysfunction via MLCK-MLC Signaling Pathway in Rats

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