Irritable bowel syndrome

Contents Lactic Acid Bacteria: Classification and Physiology, Lars Axelsson Bifidobacteria and Probiotic Action, Jean Ballongue An Update on Probiotic Bifidobacteria, Ross Crittenden The Probiotic Potential of Propionibacteria, Arthur C. Ouwehand Industrial Use and Production of Lactic Acid Bacteria, Annika Mayra- Makinen and Marc Bigret The Genus Enterococcus: Biotechnological and Safety Issues, Charles M. A. P. Franz and Wilhelm H. Holzapfel Genetics of Lactic Acid Bacteria, Lorenzo Morelli, Finn K. Vogensen, and Atte von Wright Bacteriophage and Antiphage Mechanisms of Lactic Acid Bacteria, Jytte Josephsen and Horst Neve Mathematical Modeling of Intestinal Bacteria--Host Interactions, Yuan-Kun Lee Methods for Analyzing Gut Microbiota, Miguel Gueimonde and Seppo Salminen Antimicrobial Components from Lactic Acid Bacteria, Arthur C. Ouwehand and Satu Vesterlund Lactic Acid Bacteria as a Tool for Enhancing Food Safety by Removal of Dietary Toxins, Hani El-Nezami, Hannu Mykkanen, Carolyn Haskard, Seppo Salminen, and Eeva Salminen Prebiotics and Lactic Acid Bacteria , Thea Scantlebury Manning, Robert Rastall, and Glenn Gibson Lactic Acid Bacteria in Vegetable Fermentations, Maarit Maki Lactic Acid Bacteria in Cereal-Based Products, Hannu Salovaara Human Lactic Acid Microflora and Its Role in the Welfare of the Host, Marika Mikelsaar, Reet Mandar, Epp Sepp, and Heidi Annuk Lactic Acid Bacteria and Intestinal Drug and Cholesterol Metabolism, Alice H. Lichtenstein and Barry R. Goldin Human Studies on Probiotics: What Is Scientifically Proven Today? Seppo Salminen, S. Gorbach, Yuan-Kun Lee, and Y. Benno Safety of Novel Probiotic Bacteria , Diana C. Donohue Lactic Acid Bacteria as Animal Probiotics, Juha Nousiainen, Paivi Javanainen, Jouko Setala, and Atte von Wright Lactic Acid Bacteria in Fish and Fish Farming, Einar Ringo Future Directions of Research and Product Development of Lactic, Acid Bacteria, Seppo Salminen, Arthur C. Ouwehand, Atte von Wright, and Charles Daly Index

Lactic Acid Bacteria: Microbiological and Functional Aspects

Functional somatic syndromes (FSS), like irritable bowel syndrome or fibromyalgia and other symptoms reflecting bodily distress, are common in practically all areas of medicine worldwide. Diagnostic and therapeutic approaches to these symptoms and syndromes vary substantially across and within medical specialties from biomedicine to psychiatry. Patients may become frustrated with the lack of effective treatment, doctors may experience these disorders as difficult to treat, and this type of health problem forms an important component of the global burden of disease. This review intends to develop a unifying perspective on the understanding and management of FSS and bodily distress. Firstly, we present the clinical problem and review current concepts for classification. Secondly, we propose an integrated etiological model which encompasses a wide range of biopsychosocial vulnerability and triggering factors and considers consecutive aggravating and maintaining factors. Thirdly, we systematically scrutinize the current evidence base in terms of an umbrella review of systematic reviews from 2007 to 2017 and give recommendations for treatment for all levels of care, concentrating on developments over the last 10 years. We conclude that activating, patient-involving, and centrally acting therapies appear to be more effective than passive ones that primarily act on peripheral physiology, and we recommend stepped care approaches that translate a truly biopsychosocial approach into actual management of the patient.

Management of Functional Somatic Syndromes and Bodily Distress.

Irritable bowel syndrome (IBS), one of the most frequent digestive disorders, is characterized by chronic and recurrent abdominal pain and altered bowel habit. The origin seems to be multifactorial and is still not well defined for the different subtypes. Genetic, epigenetic and sex-related modifications of the functioning of the nervous and immune-endocrine supersystems and regulation of brain-gut physiology and bile acid production and absorption are certainly involved. Acquired predisposition may act in conjunction with infectious, toxic, dietary and life event-related factors to enhance epithelial permeability and elicit mucosal microinflammation, immune activation and dysbiosis. Notably, strong evidence supports the role of bacterial, viral and parasitic infections in triggering IBS, and targeting microbiota seems promising in view of the positive response to microbiota-related therapies in some patients. However, the lack of highly predictive diagnostic biomarkers and the complexity and heterogeneity of IBS patients make management difficult and unsatisfactory in many cases, reducing patient health-related quality of life and increasing the sanitary burden. This article reviews specific alterations and interventions targeting the gut microbiota in IBS, including prebiotics, probiotics, synbiotics, non-absorbable antibiotics, diets, fecal transplantation and other potential future approaches useful for the diagnosis, prevention and treatment of IBS.

/pdf/a-review-of-microbiota-and-irritable-bowel-syndrome-future-v5oe8ywe2m.pdf

A Review of Microbiota and Irritable Bowel Syndrome: Future in Therapies

Functional bowel disorders (FBD), mainly irritable bowel syndrome (IBS) and functional constipation (FC, also called chronic idiopathic constipation), are very common worldwide. Inflammatory bowel disease (IBD), including ulcerative colitis and Crohn's disease, although less common, has a strong impact on patients' quality of life, as well as being highly expensive for our healthcare. A definite cure for those disorders is still yet to come. Over the years, several therapeutic approaches complementary or alternative to traditional pharmacological treatments, including probiotics, prebiotics, synbiotics, fibre and herbal medicinal products, have been investigated for the management of both groups of diseases. However, most available studies are biased by several drawbacks, including small samples and poor methodological quality. Probiotics, in particular Saccharomyces boulardii and Lactobacilli (among which Lactobacillus rhamnosus), synbiotics, psyllium, and some herbal medicinal products, primarily peppermint oil, seem to be effective in ameliorating IBS symptoms. Synbiotics and fibre seem to be beneficial in FC patients. The probiotic combination VSL#3 may be effective in inducing remission in patients with mild-to-moderate ulcerative colitis, in whom Escherichia coli Nissle 1917 seems to be as effective as mesalamine in maintaining remission. No definite conclusions can be drawn as to the efficacy of fibre and herbal medicinal products in IBD patients due to the low number of studies and the lack of randomized controlled trials that replicate the results obtained in the individual studies conducted so far. Thus, further, well-designed studies are needed to address the real role of these therapeutic options in the management of both FBD and IBD.

Linked Articles
This article is part of a themed section on Principles of Pharmacological Research of Nutraceuticals. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.11/issuetoc

https://bpspubs.onlinelibrary.wiley.com/doi/pdf/10.1111/bph.13632

Probiotics, fibre and herbal medicinal products for functional and inflammatory bowel disorders.

OBJECTIVE: As the lack of reliable treatment for irritable bowel syndrome (IBS) prompts interest in the development of new therapies, we aimed to systematically evaluate the effect of Lactobacillus in treating this disease. METHODS: We searched MEDLIINE, PubMed, Scopus, Web of Science and the Cochrane Central Register of Controlled Trials for the period from 1966 to August 2013 for double-blind, placebo-controlled trials investigating the efficacy of Lactobacillus treatment in the management of IBS. The studies were screened for inclusion based on randomization, controls and reported measurable outcomes. We used the Jadad score to assess the quality of the articles. The STATA 11.0 and Revman 5.0 software packages were used for the meta-analysis. The STATA 11.0 software program was also used to assess indicators of publication bias according to Begg's and Egger's tests. RESULTS: Six randomized, placebo-controlled clinical trials met the criteria and were included in the meta-analysis. The Jadad score of the articles was >3, and three articles were of high quality. We analyzed the heterogeneity of the studies and found no heterogeneity in the meta-analysis. In the forest plot, the diamond was on the right side of the vertical line and did not intersect with the line. The pooled relative risk for clinical improvement with Lactobacillus treatment was 7.69 (95% confidence interval: 2.33-25.43, p=0.0008). For adults, the pooled relative risk for clinical improvement with Lactobacillus treatment was 17.62 (95% confidence interval: 5.12-60.65, p<0.00001). For children, the pooled relative risk for clinical improvement with Lactobacillus treatment was 3.71 (95% confidence interval:1.05-13.11, p=0.04). Using the STATA 10.0 and Revman 5.0 software programs, we confirmed that Lactobacillus exhibited significant efficacy in treating IBS. CONCLUSION: Compared with the placebo, Lactobacillus treatment was found to be associated with a significantly higher rate of treatment responders in the overall population with IBS, without any side effects. As to limitations of the analysis, additional research is needed.

/pdf/therapeutic-effects-of-lactobacillus-in-treating-irritable-4nbgu95ux5.pdf

Therapeutic effects of Lactobacillus in treating irritable bowel syndrome: a meta-analysis.

Multiple myeloma (MM) is a systemic malignancy of plasma cells often characterized by sternal, rib, or back pain. This article describes how a patient who had chest pain for more than one month was mistakenly diagnosed with reflux esophagitis. Healthcare providers should be mindful of MM when determining the source of unidentified chest pain in patients.

https://cjon.ons.org/sites/default/files/LX20005104706678_first.pdf

Discovering multiple myeloma early in ambulatory patients with chest pain.

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Therapeutic effects of Lactobacillus in treating irritable bowel syndrome: a meta-analysis.

Discovering multiple myeloma early in ambulatory patients with chest pain.