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Yazbeck G, Malaeb D, Shaaban H, Sarray El Dine A, Hallit S, Hallit R. Irritable bowel syndrome (IBS) among Lebanese adults: unidentified IBS and associated factors. BMC Public Health 2023; 23:1589. [PMID: 37605160 PMCID: PMC10463955 DOI: 10.1186/s12889-023-16543-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 08/16/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Irritable bowel syndrome (IBS) is one of the most frequent functional gastrointestinal disorders, but the condition is still underdiagnosed. The high of rate of unidentified IBS by patients can be related to different factors. The aim of this study is to assess the rate of unidentified IBS among Lebanese adults and investigate the role of socio-demographic factors, anxiety, depression, insomnia and eating attitudes on IBS diagnosis. METHODS A cross-sectional study was conducted among Lebanese adults older than 18 years between June 2022 and December 2022, using a self-reporting questionnaire distributed via social media. RESULTS A total of 425 participants was enrolled in the study with around 184 (46.8%) having a possible unidentified IBS. Higher psychological distress (aOR = 1.07) and insomnia severity (aOR = 1.08) were significantly associated with higher odds of having possible unidentified IBS whereas a higher household crowding index (aOR = 0.67) was significantly associated with lower odds of having possible IBS. The correlation of eating attitudes with cigarette smoking (aOR = 1.33; p = .025; 95% CI 1.04; 1.70) and insomnia severity with cigarette smoking (aOR = .89; p = .023; 95% CI .80; .98) were significantly associated with the presence of possible IBS. In nonsmokers, higher psychological distress (aOR = 1.07) and insomnia severity (aOR = 1.10) were significantly associated with higher odds of having possible IBS. In smokers, higher BMI (aOR = .78) was significantly associated with lower odds of having possible IBS, whereas higher eating attitudes scores (more inappropriate eating) (aOR = 1.40) were significantly associated with higher odds of having possible IBS. CONCLUSION The study highlighted the implication of raising awareness about IBS among the Lebanese population to promote early diagnosis and minimize the rate of unidentified IBS by patients. Initiation of appropriate treatment plans, tailored symptomatic management approach, and diet programs should be highly encouraged.
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Affiliation(s)
- Gabriella Yazbeck
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Diana Malaeb
- College of Pharmacy, Medical Gulf University, Ajman, United Arab Emirates
| | - Hamid Shaaban
- New York Medical College, New York, USA
- Department of Infectious Disease, Saint Michael's Medical Center, Newark, NJ, USA
| | - Abir Sarray El Dine
- Department of Biomedical Sciences, School of Arts and Sciences, Lebanese International University, Beirut, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
| | - Rabih Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
- Department of Infectious Disease, Bellevue Medical Center, Mansourieh, Lebanon.
- Department of Infectious Disease, Notre Dame des Secours University Hospital Center, Street 93, Byblos, Postal Code 3, Lebanon.
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The relationship between abdominal obesity and irritable bowel syndrome in adults. MARMARA MEDICAL JOURNAL 2022. [DOI: 10.5472/marumj.1065778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Bahlouli W, Breton J, Lelouard M, L'Huillier C, Tirelle P, Salameh E, Amamou A, Atmani K, Goichon A, Bôle-Feysot C, Ducrotté P, Ribet D, Déchelotte P, Coëffier M. Stress-induced intestinal barrier dysfunction is exacerbated during diet-induced obesity. J Nutr Biochem 2020; 81:108382. [PMID: 32417626 DOI: 10.1016/j.jnutbio.2020.108382] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 02/21/2020] [Accepted: 03/13/2020] [Indexed: 02/06/2023]
Abstract
Obesity and irritable bowel syndrome (IBS) are two major public health issues. Interestingly previous data report a marked increase of IBS prevalence in morbid obese subjects compared with non-obese subjects but underlying mechanisms remain unknown. Obesity and IBS share common intestinal pathophysiological mechanisms such as gut dysbiosis, intestinal hyperpermeability and low-grade inflammatory response. We thus aimed to evaluate the link between obesity and IBS using different animal models. Male C57Bl/6 mice received high fat diet (HFD) for 12 weeks and were then submitted to water avoidance stress (WAS). In response to WAS, HFD mice exhibited higher intestinal permeability and plasma corticosterone concentration than non-obese mice. We were not able to reproduce a similar response both in ob/ob mice and in leptin-treated non-obese mice. In addition, metformin, a hypoglycemic agent, limited fasting glycaemia both in unstressed and WAS diet-induced obese mice but only partially restored colonic permeability in unstressed HFD mice. Metformin failed to improve intestinal permeability in WAS HFD mice. Finally, cecal microbiota transplantation from HFD mice in antibiotics-treated recipient mice did not reproduce the effects observed in stressed HFD mice. In conclusion, stress induced a more marked intestinal barrier dysfunction in diet-induced obese mice compared with non-obese mice that seems to be independent of leptin, glycaemia and gut microbiota. These data should be further confirmed and the role of the dietary composition should be studied.
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Affiliation(s)
- Wafa Bahlouli
- Normandie University, UNIROUEN, INSERM UMR 1073 "Nutrition, inflammation and gut-brain axis", 76183 Rouen, France; Institute of Research and Innovation in Biomedicine (IRIB), UNIROUEN, 76183 Rouen, France
| | - Jonathan Breton
- Normandie University, UNIROUEN, INSERM UMR 1073 "Nutrition, inflammation and gut-brain axis", 76183 Rouen, France; Institute of Research and Innovation in Biomedicine (IRIB), UNIROUEN, 76183 Rouen, France
| | - Mauranne Lelouard
- Normandie University, UNIROUEN, INSERM UMR 1073 "Nutrition, inflammation and gut-brain axis", 76183 Rouen, France; Institute of Research and Innovation in Biomedicine (IRIB), UNIROUEN, 76183 Rouen, France
| | - Clément L'Huillier
- Normandie University, UNIROUEN, INSERM UMR 1073 "Nutrition, inflammation and gut-brain axis", 76183 Rouen, France; Institute of Research and Innovation in Biomedicine (IRIB), UNIROUEN, 76183 Rouen, France
| | - Pauline Tirelle
- Normandie University, UNIROUEN, INSERM UMR 1073 "Nutrition, inflammation and gut-brain axis", 76183 Rouen, France; Institute of Research and Innovation in Biomedicine (IRIB), UNIROUEN, 76183 Rouen, France
| | - Emmeline Salameh
- Normandie University, UNIROUEN, INSERM UMR 1073 "Nutrition, inflammation and gut-brain axis", 76183 Rouen, France; Institute of Research and Innovation in Biomedicine (IRIB), UNIROUEN, 76183 Rouen, France
| | - Asma Amamou
- Normandie University, UNIROUEN, INSERM UMR 1073 "Nutrition, inflammation and gut-brain axis", 76183 Rouen, France; Institute of Research and Innovation in Biomedicine (IRIB), UNIROUEN, 76183 Rouen, France
| | - Karim Atmani
- Normandie University, UNIROUEN, INSERM UMR 1073 "Nutrition, inflammation and gut-brain axis", 76183 Rouen, France; Institute of Research and Innovation in Biomedicine (IRIB), UNIROUEN, 76183 Rouen, France
| | - Alexis Goichon
- Normandie University, UNIROUEN, INSERM UMR 1073 "Nutrition, inflammation and gut-brain axis", 76183 Rouen, France; Institute of Research and Innovation in Biomedicine (IRIB), UNIROUEN, 76183 Rouen, France
| | - Christine Bôle-Feysot
- Normandie University, UNIROUEN, INSERM UMR 1073 "Nutrition, inflammation and gut-brain axis", 76183 Rouen, France; Institute of Research and Innovation in Biomedicine (IRIB), UNIROUEN, 76183 Rouen, France
| | - Philippe Ducrotté
- Normandie University, UNIROUEN, INSERM UMR 1073 "Nutrition, inflammation and gut-brain axis", 76183 Rouen, France; Institute of Research and Innovation in Biomedicine (IRIB), UNIROUEN, 76183 Rouen, France; Department of Gastroenterology, Rouen University Hospital, 76183 Rouen, France
| | - David Ribet
- Normandie University, UNIROUEN, INSERM UMR 1073 "Nutrition, inflammation and gut-brain axis", 76183 Rouen, France; Institute of Research and Innovation in Biomedicine (IRIB), UNIROUEN, 76183 Rouen, France
| | - Pierre Déchelotte
- Normandie University, UNIROUEN, INSERM UMR 1073 "Nutrition, inflammation and gut-brain axis", 76183 Rouen, France; Institute of Research and Innovation in Biomedicine (IRIB), UNIROUEN, 76183 Rouen, France; Department of Nutrition, Rouen University Hospital, 76183 Rouen, France
| | - Moïse Coëffier
- Normandie University, UNIROUEN, INSERM UMR 1073 "Nutrition, inflammation and gut-brain axis", 76183 Rouen, France; Institute of Research and Innovation in Biomedicine (IRIB), UNIROUEN, 76183 Rouen, France; Department of Nutrition, Rouen University Hospital, 76183 Rouen, France.
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Creed F. Review article: the incidence and risk factors for irritable bowel syndrome in population-based studies. Aliment Pharmacol Ther 2019; 50:507-516. [PMID: 31313850 DOI: 10.1111/apt.15396] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 05/03/2019] [Accepted: 06/12/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND In the absence of prior gastrointestinal infection, the risk factors for irritable bowel syndrome (IBS) are not well established. AIM To identify the incidence and risk factors for IBS in general population samples METHODS: Narrative review of population-based studies. Electronic databases were searched using the keywords "incidence," "onset," "epidemiology," "population," "risk factors" with "irritable bowel syndrome" with subsequent hand searching. Inclusion criteria were: population-based, adults, prospective design (including retrospective case cohorts), clinical or research diagnosis of IBS and exclusion of individuals who had IBS prior to recruitment. RESULTS Of 1963 papers, 38 were included; all provided data on risk factors, 27 reported incidence. The median incidence of physician-diagnosed IBS in 19 general population cohorts was 38.5 per 10 000 person-years (interquartile range = 20-45.3). In 14 cohorts with specific medical disorders, median incidence was 92 per 10 000 person-years (IQR: 73.9-119). Apart from gastroenteritis, the most common risk factors were other medical disorders, female sex, age (both young and old), anxiety and depression, life events/stress, frequent healthcare use, pain and sleep disorders. The results were conflicting for alcohol consumption, smoking and BMI. Incidence rates were similar in different countries but risk factors differed. CONCLUSIONS Incidence rates were generally lower than previous estimates reflecting physician-diagnosed IBS. The results highlight the importance of other medical and psychosocial problems in the onset of IBS in addition to prior gastrointestinal infections. Aetiological research could be enhanced by studying the underlying mechanisms relating to all of these risk factors.
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Affiliation(s)
- Francis Creed
- Neuroscience and Mental Health, University of Manchester, Manchester, UK
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Impact of occupational stress on irritable bowel syndrome pathophysiology and potential management in active duty noncombat Greek military personnel: a multicenter prospective survey. Eur J Gastroenterol Hepatol 2019; 31:954-963. [PMID: 31107738 DOI: 10.1097/meg.0000000000001439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Irritable bowel syndrome (IBS) is one of the gut-brain axis interaction disorders. It has global distribution with varying prevalence and particular financial and psychological consequences. IBS has been associated with stress and anxiety, conditions that are usually prevalent in the army. There are scarce data investigating the impact of IBS on noncombat active duty military without reports of Greek military or stress in the occupational environment. MATERIALS AND METHODS The main exclusion criteria in our noncombat military multicenter prospective survey were gastrointestinal pathologies, malignancies, hematochezia, recent infections and antibiotics prescription, and pregnancy. Questionnaires included a synthesis of baseline information, lifestyle, and diet, psychological and stress-investigating scales and the IBS diagnosis checklist. Hospital Anxiety and Depression Scale and Rome IV criteria were utilized. RESULTS Among 1605 participants included finally, the prevalence of IBS was 8% and 131 cases were identified. Women were more vulnerable to IBS, although male sex was prevalent at a ratio of 3.5 : 1 (male:female) in the entire sample. The mean age of all participants was 23.85 years; most of the IBS patients were older than thirty. Abnormal anxiety scores and high levels of occupational stress were related to an IBS diagnosis. DISCUSSION This prospective multicenter survey showed, for the first time, the potential impact of occupational stress on IBS in active duty noncombat Greek Military personnel. The diagnosis of IBS by questionnaire is a quick, affordable way that can upgrade, by its management, the quality of life and relieve from the military burden. Our results are comparable with previous studies, although large-scale epidemiological studies are required for the confirmation of a possible causative relationship.
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Arasteh P, Maharlouei N, Eghbali SS, Amini M, Lankarani KB, Malekzadeh R. A Comprehensive Look at Irritable Bowel Syndrome and its Associated Factors Considering the Rome IV Criteria: A Penalized Smoothly Clipped Absolute Deviation Regression Approach in the Pars Cohort Study. Middle East J Dig Dis 2018; 10:149-159. [PMID: 30186578 PMCID: PMC6119837 DOI: 10.15171/mejdd.2018.104] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 06/19/2018] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND
After the introduction of the Rome IV criteria for the diagnosis of irritable bowel syndrome (IBS),
studies on the clinical significance of the new criteria in the settings of a large study has been scarce.
Objective: Herein we used the infrastructures provided by one the largest cohort studies in Iran to
evaluate the epidemiological features related to IBS.
METHODS
A total of 9264 participants, were enrolled in the initial registry. Diagnosis of IBS was done using
the Rome IV criteria. Individuals with IBS were compared with a control group. Since the study
included a large sample size of patients, we used the penalized smoothly clipped absolute deviation
(SCAD) regression analysis to construct a model for the evaluation of factors associated with IBS.
RESULTS
Overall, data of 9163 participants entered the final analysis. In total, 1067 (11.6%) individuals
were diagnosed with IBS, among which 57 (5.3%) were diarrhea dominant (IBS-D), 380 (35.6%)
were constipation dominant (IBS-C), and 630 (59%) did not mention having any of the two (IBS-U).
In the regression model, back pain/arthralgia (OR: 1.98, 95% CI: 1.65 - 2.40), insomnia (OR:
1.65, 95% CI: 1.40 - 1.93), depression (OR: 1.64, 95% CI: 1.38 - 1.95), female sex (OR: 1.58, 95%
CI: 1.27 - 1.96), anxiety (OR: 1.43, 95% CI: 1.21 - 1.69), and being married (OR: 1.23, 95% CI:
1.03 - 1.48), were associated with higher rates of IBS. We found that IBS prevalence displays a peak
at the age of 41 years for both men and women.
CONCLUSION
The present study provides a background for follow-up studies to be conducted in order to
evaluate causality between IBS and some major diseases such as liver disease. We also found that
opium use, although not statistically significant, in addition to sex, education, back/joint pain,
depression, insomnia, anxiety, and marital status might be a contributing factor in IBS.
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Affiliation(s)
- Peyman Arasteh
- Department of MPH, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Najmeh Maharlouei
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Sajjad Eghbali
- Department of Pathology and Lab Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Mitra Amini
- Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kamran B Lankarani
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Limketkai BN, Sepulveda R, Hing T, Shah ND, Choe M, Limsui D, Shah S. Prevalence and factors associated with gluten sensitivity in inflammatory bowel disease. Scand J Gastroenterol 2018; 53:147-151. [PMID: 29216767 DOI: 10.1080/00365521.2017.1409364] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Gluten sensitivity (GS) arises with celiac disease and has also been found in non-celiac disorders, although its characteristics in inflammatory bowel disease (IBD) are unclear. This study evaluated the prevalence of GS and factors associated with GS in IBD. METHODS Adult IBD patients at a tertiary-care medical center completed a survey of their demographics, medical history, family history, social history and symptoms. Data on IBD characteristics were abstracted from the medical records. Descriptive analyses estimated the prevalence of GS. Multivariable logistic regression assessed the association between GS and patient or disease factors. RESULTS Of 102 IBD patients (55 Crohn's disease [CD], 46 ulcerative colitis [UC] and 3 IBD-unclassified), GS was reported in 23.6 and 27.3% of CD and UC patients, respectively. Common symptoms included fatigue, abdominal pain, diarrhea, bloating and hematochezia. There was no difference in these symptoms when comparing patients with and without GS. When evaluating IBD-related factors, GS was associated with having had a recent flare (adjusted odds ratio [aOR] 7.4; 95% confidence interval [CI] 1.6-34.1), stenotic disease in CD (aOR 4.7; 95% CI 1.1-20.2) and dermatologic manifestations (aOR 5.5; 95% CI 1.2-24.1). CONCLUSION GS was common in IBD and associated with having had a recent flare. GS may be transient for some patients, whereby dietary recommendations during and after a flare could focus on the avoidance of specific food triggers with possible reintroduction of these foods over time. This study prompts further prospective investigation into the temporal evolution of GS in IBD.
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Affiliation(s)
- Berkeley N Limketkai
- a Division of Gastroenterology & Hepatology , Stanford University School of Medicine , Stanford , CA , USA
| | - Rachel Sepulveda
- a Division of Gastroenterology & Hepatology , Stanford University School of Medicine , Stanford , CA , USA
| | - Tressia Hing
- a Division of Gastroenterology & Hepatology , Stanford University School of Medicine , Stanford , CA , USA
| | - Neha D Shah
- b Department of Clinical Nutrition , Stanford Health Care , Palo Alto , CA , USA
| | - Monica Choe
- a Division of Gastroenterology & Hepatology , Stanford University School of Medicine , Stanford , CA , USA
| | - David Limsui
- a Division of Gastroenterology & Hepatology , Stanford University School of Medicine , Stanford , CA , USA
| | - Shamita Shah
- a Division of Gastroenterology & Hepatology , Stanford University School of Medicine , Stanford , CA , USA
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Increased Prevalence of Irritable Bowel Syndrome in a Cohort of French Morbidly Obese Patients Candidate for Bariatric Surgery. Obes Surg 2017; 26:1525-30. [PMID: 26424705 DOI: 10.1007/s11695-015-1907-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Only a few recent reports have suggested a correlation between obesity and irritable bowel syndrome (IBS). We aimed to determine the prevalence and severity of IBS in a prospective cohort of obese patients undergoing bariatric surgery in Nice Hospital (France). METHODS One hundred obese patients were included prospectively before bariatric surgery. A diagnosis of IBS and each subtype was performed according to Rome-III criteria using a Bristol scale for stool consistency. Patients provided information on IBS-related comorbidities, including chronic fatigue, migraine, lower back pain, gastroesophageal reflux disease (GERD), genitourinary problems, and dyspepsia. Patients completed questionnaires to assess the severity of IBS, GERD, psychological factors (anxiety, depression), fatigue, and quality of life. RESULTS Thirty patients fulfilled the Rome-III criteria for IBS. There was no difference in age, gender, or BMI between obese patients with or without IBS. Obese patients with IBS reported a significantly higher prevalence of GERD, migraines, lower back pain, genitourinary problems, chronic fatigue, and dyspepsia. Obese patients with IBS had significant higher scores of fatigue, anxiety, depression, and poorer quality of life. Obese patients that had both IBS and GERD had significantly higher IBS severity scores than those without GERD. In a logistic regression model including BMI, anxiety, depression, gender, and GERD score, only anxiety was significantly and independently associated with IBS. CONCLUSIONS Thirty percent of obese patients had IBS: its severity was not correlated with BMI. However, anxiety was independently associated with IBS, suggesting that psychological factors are key features of IBS, whatever the presence of obesity.
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Borbély YM, Osterwalder A, Kröll D, Nett PC, Inglin RA. Diarrhea after bariatric procedures: Diagnosis and therapy. World J Gastroenterol 2017; 23:4689-4700. [PMID: 28765690 PMCID: PMC5514634 DOI: 10.3748/wjg.v23.i26.4689] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Revised: 03/30/2017] [Accepted: 06/19/2017] [Indexed: 02/07/2023] Open
Abstract
Diarrhea after bariatric procedures, mainly those with malabsorptive elements including Roux-Y Gastric Bypass and Biliopancreatic Diversion, is common and an essential determinant of quality of life and micro- and macronutrient deficiencies. Bariatric surgery is the only sustainably successful method to address morbid obesity and its comorbidities, particularly gaining more and more importance in the specific treatment of diabetic patients. Approximately half a million procedures are annually performed around the world, with numbers expected to rise drastically in the near future. A multitude of factors exert their influence on bowel habits; preoperative comorbidities and procedure-related aspects are intertwined with postoperative nutritional habits. Diagnosis may be challenging owing to the characteristics of post-bariatric surgery anatomy with hindered accessibility of excluded segments of the small bowel and restriction at the gastric level. Conventional testing measures, if available, generally yield low accuracy and are usually not validated in this specific population. Limited trials of empiric treatment are a practical alternative and oftentimes an indispensable part of the diagnostic process. This review provides an overview of causes for chronic post-bariatric surgery diarrhea and details the particularities of its diagnosis and treatment in this specific patient population. Topics of current interest such as the impact of gut microbiota and the influence of bile acids on morbid obesity and especially their role in diarrhea are highlighted in order to provide a better understanding of the specific problems and chances of future treatment in post-bariatric surgery patients.
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Boeckxstaens GE, Drug V, Dumitrascu D, Farmer AD, Hammer J, Hausken T, Niesler B, Pohl D, Pojskic L, Polster A, Simren M, Goebel-Stengel M, Van Oudenhove L, Vassallo M, Wensaas KA, Aziz Q, Houghton LA. Phenotyping of subjects for large scale studies on patients with IBS. Neurogastroenterol Motil 2016; 28:1134-47. [PMID: 27319981 DOI: 10.1111/nmo.12886] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 05/17/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND Irritable bowel syndrome (IBS) is a complex condition with multiple factors contributing to its aetiology and pathophysiology. Aetiologically these include genetics, life-time events and environment, and physiologically, changes in motility, central processing, visceral sensitivity, immunity, epithelial permeability and gastrointestinal microflora. Such complexity means there is currently no specific reliable biomarker for IBS, and thus IBS continues to be diagnosed and classified according to symptom based criteria, the Rome Criteria. Carefully phenotyping and characterisation of a 'large' pool of IBS patients across Europe and even the world however, might help identify sub-populations with accuracy and consistency. This will not only aid future research but improve tailoring of treatment and health care of IBS patients. PURPOSE The aim of this position paper is to discuss the requirements necessary to standardize the process of selecting and phenotyping IBS patients and how to organise the collection and storage of patient information/samples in such a large multi-centre pan European/global study. We include information on general demographics, gastrointestinal symptom assessment, psychological factors, quality of life, physiological evaluation, genetic/epigenetic and microbiota analysis, biopsy/blood sampling, together with discussion on the organisational, ethical and language issues associated with implementing such a study. The proposed approach and documents selected to be used in such a study was the result of a thoughtful and thorough four-year dialogue amongst experts associated with the European COST action BM1106 GENIEUR (www.GENIEUR.eu).
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Affiliation(s)
- G E Boeckxstaens
- Translational Research Center for Gastrointestinal Disorders, KULeuven & Department of Gastroenterology and Hepatology, University Hospital Leuven, Leuven, Belgium
| | - V Drug
- Gastroenterology Department, University Hospital "St Spiridon", Gr. T.Popa University of Medicine and Pharmacy, Iasi, Romania
| | - D Dumitrascu
- 2nd Medical Dept., Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - A D Farmer
- Wingate Institute of Neurogastroenterology, Barts and The London School of Medicine and Dentistry, London, UK.,Department of Gastroenterology, University Hospitals of North Midlands, Stoke on Trent, UK
| | - J Hammer
- Medizinische Universität Wien, Universitätsklinik für Innere Medizin 3, Vienna, Austria
| | - T Hausken
- Department of Medicine, Unit of Gastroenterology, Haukeland University Hospital, Bergen, Norway
| | - B Niesler
- Department of Human Molecular Genetics, University of Heidelberg, Heidelberg, Germany
| | - D Pohl
- Division of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland
| | - L Pojskic
- Institute for Genetic Engineering and Biotechnology, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - A Polster
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - M Simren
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Center for Functional Gastrointestinal and Motility Disorders, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - M Goebel-Stengel
- Department of Internal Medicine, Martin-Luther-Krankenhaus, Berlin, Germany
| | - L Van Oudenhove
- Translational Research Center for Gastrointestinal Disorders, KULeuven & Department of Gastroenterology and Hepatology, University Hospital Leuven, Leuven, Belgium
| | - M Vassallo
- Department of Medicine, Mater Dei Hospital, Tal-Qroqq, Malta
| | - K-A Wensaas
- Uni Research Health, Research Unit for General Practice, Bergen, Norway
| | - Q Aziz
- Wingate Institute of Neurogastroenterology, Barts and The London School of Medicine and Dentistry, London, UK
| | - L A Houghton
- Leeds Institute of Biomedical and Clinical Sciences, University of Leeds and Leeds Gastroenterology Institute, Leeds Teaching Hospitals Trust, Leeds, UK.,Centre for Gastrointestinal Sciences, University of Manchester, Manchester, UK.,Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA
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