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Ford AC, Staudacher HM, Talley NJ. Postprandial symptoms in disorders of gut-brain interaction and their potential as a treatment target. Gut 2024; 73:1199-1211. [PMID: 38697774 DOI: 10.1136/gutjnl-2023-331833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 04/23/2024] [Indexed: 05/05/2024]
Abstract
Postprandial, or meal-related, symptoms, such as abdominal pain, early satiation, fullness or bloating, are often reported by patients with disorders of gut-brain interaction, including functional dyspepsia (FD) or irritable bowel syndrome (IBS). We propose that postprandial symptoms arise via a distinct pathophysiological process. A physiological or psychological insult, for example, acute enteric infection, leads to loss of tolerance to a previously tolerated oral food antigen. This enables interaction of both the microbiota and the food antigen itself with the immune system, causing a localised immunological response, with activation of eosinophils and mast cells, and release of inflammatory mediators, including histamine and cytokines. These have more widespread systemic effects, including triggering nociceptive nerves and altering mood. Dietary interventions, including a diet low in fermentable oligosaccharides, disaccharides, monosaccharides and polyols, elimination of potential food antigens or gluten, IgG food sensitivity diets or salicylate restriction may benefit some patients with IBS or FD. This could be because the restriction of these foods or dietary components modulates this pathophysiological process. Similarly, drugs including proton pump inhibitors, histamine-receptor antagonists, mast cell stabilisers or even tricyclic or tetracyclic antidepressants, which have anti-histaminergic actions, all of which are potential treatments for FD and IBS, act on one or more of these mechanisms. It seems unlikely that food antigens driving intestinal immune activation are the entire explanation for postprandial symptoms in FD and IBS. In others, fermentation of intestinal carbohydrates, with gas release altering reflex responses, adverse reactions to food chemicals, central mechanisms or nocebo effects may dominate. However, if the concept that postprandial symptoms arise from food antigens driving an immune response in the gastrointestinal tract in a subset of patients is correct, it is paradigm-shifting, because if the choice of treatment were based on one or more of these therapeutic targets, patient outcomes may be improved.
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Affiliation(s)
- Alexander C Ford
- Leeds Gastroenterology Institute, St James's University Hospital, Leeds, UK
| | - Heidi M Staudacher
- Deakin University-Geelong Waterfront Campus, Geelong, Victoria, Australia
| | - Nicholas J Talley
- Health, University of Newcastle, Callaghan, New South Wales, Australia
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MacIntosh A, Heenan PE, Wright-McNaughton M, Frampton C, Skidmore P, Wall CL, Muir J, Talley NJ, Roy NC, Gearry RB. The relationship between fermentable carbohydrates and post-prandial bowel symptoms in patients with functional bowel disorders. Front Nutr 2023; 10:1060928. [PMID: 36819701 PMCID: PMC9932028 DOI: 10.3389/fnut.2023.1060928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 01/10/2023] [Indexed: 02/05/2023] Open
Abstract
Background and aims A low fermentable oligosaccharide, disaccharide, monosaccharide, and polyols (FODMAP) diet alleviates symptoms of irritable bowel syndrome (IBS). We aimed to investigate the relationship between habitual FODMAP intake and post-prandial bowel symptoms in adults with IBS, functional diarrhoea (FD), or constipation (FD) (functional bowel disorders), and in healthy adults (controls). Methods 292 participants (173 with functional bowel disorders and 119 controls) completed a food and symptom times diary. Estimated meal portion sizes were entered into the Monash FODMAP Calculator to analyse FODMAP content. Wilcoxon and ANOVA tests were used to investigate the relationship between FODMAP intake and post-prandial bowel symptoms. Results IBS participants experienced more post-prandial bowel symptoms compared to participants with other functional bowel disorders or controls. Meals associated with abdominal pain contained on average increased excess fructose (0.31 g vs. 0.18 g, p < 0.05), sorbitol (0.27 g vs. 0.10 g, p < 0.01), and total FODMAP (3.46 g vs. 2.96 g, p < 0.05) compared to meals not associated with pain. Abdominal swelling was associated with increased sorbitol (0.33 g vs. 0.11 g, p < 0.01), and total FODMAP (3.26 g vs. 3.02 g, p < 0.05) consumption. Abdominal bloating was associated with increased galacto oligosaccharide consumption (0.18 g vs. 0.14 g, p < 0.05). Conclusion These findings support the role of FODMAP in post-prandial bowel symptom onset, however, the amount and type of FODMAP triggering symptoms vary between individuals. Future research should investigate the relationship between the effect of individual FODMAP consumption on post-prandial bowel symptoms for each subtype, the interaction of FODMAP with differing functional bowel disorders and whether longitudinally symptoms and dietary intake are stable.
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Affiliation(s)
- Alice MacIntosh
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | - Phoebe E. Heenan
- Department of Medicine, University of Otago, Christchurch, New Zealand,High-Value Nutrition National Science Challenge, Liggins Institute at the University of Auckland, Auckland, New Zealand
| | | | - Chris Frampton
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Paula Skidmore
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | - Catherine L. Wall
- Department of Medicine, University of Otago, Christchurch, New Zealand,High-Value Nutrition National Science Challenge, Liggins Institute at the University of Auckland, Auckland, New Zealand
| | - Jane Muir
- Department of Gastroenterology, Monash University, Melbourne, VIC, Australia
| | - Nicholas Joseph Talley
- School of Medicine, University of Newcastle, Newcastle, NSW, Australia,NHMRC Centre of Research Excellence in Digestive Health, University of Newcastle, Newcastle, NSW, Australia
| | - Nicole Clemence Roy
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand,High-Value Nutrition National Science Challenge, Liggins Institute at the University of Auckland, Auckland, New Zealand,Riddet Institute, Palmerston North, New Zealand
| | - Richard B. Gearry
- Department of Medicine, University of Otago, Christchurch, New Zealand,High-Value Nutrition National Science Challenge, Liggins Institute at the University of Auckland, Auckland, New Zealand,*Correspondence: Richard B. Gearry,
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Two Gold Kiwifruit Daily for Effective Treatment of Constipation in Adults-A Randomized Clinical Trial. Nutrients 2022; 14:nu14194146. [PMID: 36235798 PMCID: PMC9572406 DOI: 10.3390/nu14194146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 09/23/2022] [Accepted: 10/03/2022] [Indexed: 11/16/2022] Open
Abstract
Chronic constipation is highly prevalent worldwide and may be managed with two green or three gold kiwifruit daily. It is unknown whether a smaller standard serve of gold kiwifruit (two daily) is as effective in constipation management. The study aimed to improve chronic constipation with two gold kiwifruit and psyllium in lieu of a placebo daily over four weeks. Adult participants (18-65 years) with functional constipation (FC, n = 11), constipation-predominant irritable bowel syndrome (IBS-C, n = 13), and healthy controls (n = 32) were block-randomized to the treatment order: gold kiwifruit (2/day) or psyllium (fiber-matched, 7.5 g/day) for four weeks, followed by four weeks washout before crossover. Outcomes included alterations of Gastrointestinal Symptom Rating Scale (GSRS) domains and weekly complete spontaneous bowel movements (CSBM) as part of a larger study. Both interventions reduced GSRS constipation domain scores in all subjects compared to baseline values (p = 0.004). All participants reported significantly more weekly CSBM (p = 0.014). Two gold kiwifruit decreased straining (p = 0.021). Two gold kiwifruit daily are as effective as fiber-matched psyllium in treating constipation in adults and should be considered as a treatment option.
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Moshiree B, Heidelbaugh JJ, Sayuk GS. A Narrative Review of Irritable Bowel Syndrome with Diarrhea: A Primer for Primary Care Providers. Adv Ther 2022; 39:4003-4020. [PMID: 35869354 PMCID: PMC9402521 DOI: 10.1007/s12325-022-02224-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 06/14/2022] [Indexed: 12/09/2022]
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Melchior C, Algera J, Colomier E, Törnblom H, Simrén M. Irritable bowel syndrome with food-related symptoms: Future directions in the clinical management. United European Gastroenterol J 2022; 10:594-600. [PMID: 35727703 PMCID: PMC9278572 DOI: 10.1002/ueg2.12265] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/25/2022] [Indexed: 11/08/2022] Open
Abstract
The majority of patients with irritable bowel syndrome (IBS) experiences food-related symptoms, which are associated with high symptom burden, reduced quality of life, increased healthcare consumption and reduced intake of certain nutrients. In this review we aimed to describe a clinically useful approach for physicians, by presenting the latest progress in knowledge and its translation to management in IBS patients with food-related symptoms, as well as the underlying mechanisms involved. The research tools currently available that can be used in the future for a better characterization of this subgroup of patients are also discussed. Working towards this approach could lead to a more individualised work-up and management of IBS patients with food-related symptoms.
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Affiliation(s)
- Chloé Melchior
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,INSERM UMR 1073, Institute for Research and Innovation in Biomedicine, Normandy University, Rouen, France.,Rouen University Hospital, Gastroenterology Department and INSERM CIC-CRB 1404, Rouen, France
| | - Joost Algera
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Esther Colomier
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Translational Research for Gastrointestinal Disorders, University Hospital KU Leuven, University of Leuven, Leuven, Belgium
| | - Hans Törnblom
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Magnus Simrén
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Centre for Functional GI and Motility Disorders, University of North Carolina, Chapel Hill, North Carolina, USA
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Duracinsky M, Archbold S, Lobo B, Bessonneau P, Thonon F, Santos J, Guagnozzi D, Payakachat N, Coffin B, Azpiroz F, Whorwell PJ, Chassany O. The Intestinal Gas Questionnaire (IGQ): Psychometric validation of a new instrument for measuring gas-related symptoms and their impact on daily life among general population and irritable bowel syndrome. Neurogastroenterol Motil 2022; 34:e14202. [PMID: 34145682 PMCID: PMC9285021 DOI: 10.1111/nmo.14202] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 04/20/2021] [Accepted: 05/20/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Gas-related symptoms (GRS) are common in the general population (GPop) and among patients with disorders of gut-brain interactions but there is no patient-reported outcome evaluating these symptoms and their impact on daily life. We have previously developed a 43-item intestinal gas questionnaire (IGQ). The aim of the present study is to perform a psychometric validation of this instrument. METHODS Participants (119 from the GPop and 186 irritable bowel syndrome (IBS) patients) were recruited from 3 countries (UK, Spain, France). IBS patients fulfilled ROME IV criteria with an IBS severity score between 150 and 300. Participants completed the IGQ, the functional Digestive Disorders Quality of Life (FDDQL), and the EQ-5D. A subgroup (n = 90) repeated the IGQ completion after 7 days on paper or electronically. RESULTS From the original IGQ questionnaire, 26 items were deleted because of poor performance. Confirmatory factorial analysis on the remaining 17 items (7 symptom and 10 impact items) yielded a 6-factor structure accounting for 67% of the variance for bloating (6 items), flatulence (3), belching (2), bad breath (2), stomach rumbling (2), and difficult gas evacuation (2). Global score (0-100) was worse among IBS vs GPop (40 ± 15 vs 33 ± 17; p = 0.0016). At the second visit, the intraclass correlation coefficient of IGQ scores was between 0.71 and 0.86 (n = 67) for test-retest reliability and 0.61-0.87 (n = 64) for equivalence between electronic and paper versions of IGQ. CONCLUSION The IGQ available in paper and electronic versions in 3 languages is a robust instrument for capturing and measuring GRS and their impact on daily life.
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Affiliation(s)
- Martin Duracinsky
- Patient‐Centered Reported OutcomesParis‐Diderot UniversityParisFrance,Health Economics Clinical Trial Unit (URC‐ECO)Hotel‐Dieu HospitalAP‐HPParisFrance
| | - Sharon Archbold
- Neurogastroenterology UnitSchool of Medical SciencesFaculty of Biology, Medicine and HealthWythenshawe HospitalUniversity of ManchesterManchesterUK
| | - Beatriz Lobo
- Digestive System Research UnitUnitat de Fisiología i Fisiopatología DigestivaVall d’Hebron Institut de Recerca (VHIR)BarcelonaSpain,Servei de Aparell DigestiuVall d’Hebron Hospital UniversitariVall d’Hebron Barcelona Hospital CampusBarcelonaSpain,CIBER de Enfermedades Hepaticas y Digestivas (CIBERHED)Instituto de Salud Carlos IIIMadridSpain,Facultat de MedicinaUniversitat Autònoma de BarcelonaBellaterraSpain
| | - Pascal Bessonneau
- Patient‐Centered Reported OutcomesParis‐Diderot UniversityParisFrance
| | - Frédérique Thonon
- Patient‐Centered Reported OutcomesParis‐Diderot UniversityParisFrance
| | - Javier Santos
- Digestive System Research UnitUnitat de Fisiología i Fisiopatología DigestivaVall d’Hebron Institut de Recerca (VHIR)BarcelonaSpain,Servei de Aparell DigestiuVall d’Hebron Hospital UniversitariVall d’Hebron Barcelona Hospital CampusBarcelonaSpain,CIBER de Enfermedades Hepaticas y Digestivas (CIBERHED)Instituto de Salud Carlos IIIMadridSpain,Facultat de MedicinaUniversitat Autònoma de BarcelonaBellaterraSpain
| | - Danila Guagnozzi
- Digestive System Research UnitUnitat de Fisiología i Fisiopatología DigestivaVall d’Hebron Institut de Recerca (VHIR)BarcelonaSpain,Servei de Aparell DigestiuVall d’Hebron Hospital UniversitariVall d’Hebron Barcelona Hospital CampusBarcelonaSpain,CIBER de Enfermedades Hepaticas y Digestivas (CIBERHED)Instituto de Salud Carlos IIIMadridSpain,Facultat de MedicinaUniversitat Autònoma de BarcelonaBellaterraSpain
| | - Nalin Payakachat
- Department of Pharmacy PracticeCollege of PharmacyUniversity of Arkansas for Medical SciencesLittle RockARUSA
| | - Benoit Coffin
- Gastroenterology DepartmentLouis‐Mourier HospitalAP‐HPColombesFrance
| | - Fernando Azpiroz
- Digestive System Research UnitUnitat de Fisiología i Fisiopatología DigestivaVall d’Hebron Institut de Recerca (VHIR)BarcelonaSpain,Servei de Aparell DigestiuVall d’Hebron Hospital UniversitariVall d’Hebron Barcelona Hospital CampusBarcelonaSpain,CIBER de Enfermedades Hepaticas y Digestivas (CIBERHED)Instituto de Salud Carlos IIIMadridSpain,Facultat de MedicinaUniversitat Autònoma de BarcelonaBellaterraSpain
| | - Peter J. Whorwell
- Neurogastroenterology UnitSchool of Medical SciencesFaculty of Biology, Medicine and HealthWythenshawe HospitalUniversity of ManchesterManchesterUK
| | - Olivier Chassany
- Patient‐Centered Reported OutcomesParis‐Diderot UniversityParisFrance,Health Economics Clinical Trial Unit (URC‐ECO)Hotel‐Dieu HospitalAP‐HPParisFrance
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Fawson S, Dibley L, Smith K, Batista J, Artom M, Windgassen S, Syred J, Moss-Morris R, Norton C. Developing an Online Program for Self-Management of Fatigue, Pain, and Urgency in Inflammatory Bowel Disease: Patients' Needs and Wants. Dig Dis Sci 2022; 67:2813-2826. [PMID: 34146202 PMCID: PMC8214381 DOI: 10.1007/s10620-021-07109-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 06/09/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Inflammatory bowel disease (IBD) is a lifelong relapsing-remitting condition, characterized by troublesome symptoms including fatigue, pain, and bowel urgency. These symptoms can persist even in clinical remission and have a debilitating impact on social, work-related and intimate domains of life. Symptom self-management can be challenging for some patients, who could potentially benefit from an online self-management tool. AIMS We aimed to understand patients' symptom self-management strategies and preferred design for a future online symptom self-management intervention. METHODS Using exploratory qualitative methods, we conducted focus group and individual interviews with 40 people with IBD recruited from UK clinics and from community-dwelling members of the Crohn's and Colitis UK charity; data were collected using a digital audio recorder, and transcribed and anonymized by a third party (professional) transcriber. We used framework analysis for focus group data and thematic analysis for interview data. RESULTS The data provided three core themes: ways of coping; intervention functionality; and intervention content. Participants attempt to manage all three symptoms simultaneously, recognizing the combined influence of factors such as food, drink, stress, and exercise on all symptoms. They wanted an accessible online intervention functioning across several platforms, with symptom and medication management, and activity-tracking features. CONCLUSIONS Patients reported numerous ways of self-managing symptoms of fatigue, pain, and urgency/incontinence related to IBD and expressed their needs for content, design, and functionality of the proposed intervention. Based on this and existing intervention development literature, the IBD-BOOST online self-management intervention has now been developed and is undergoing testing.
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Affiliation(s)
- Sophie Fawson
- Institute of Psychiatry, Psychology and Neurosciences, King’s College London, London, UK
| | - Lesley Dibley
- Institute for Lifecourse Development, School of Health Sciences, Faculty of Education, Health, and Human Sciences, University of Greenwich, Avery Hill Campus, London, UK
| | - Kaylee Smith
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London, UK
| | - Joanna Batista
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London, UK
| | - Micol Artom
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London, UK
| | - Sula Windgassen
- Institute of Psychiatry, Psychology and Neurosciences, King’s College London, London, UK
| | - Jonathan Syred
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London, UK
| | - Rona Moss-Morris
- Institute of Psychiatry, Psychology and Neurosciences, King’s College London, London, UK
| | - Christine Norton
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London, UK
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Dietary Fiber and Prebiotic Compounds in Fruits and Vegetables Food Waste. SUSTAINABILITY 2021. [DOI: 10.3390/su13137219] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The fruits and vegetables processing industry is one of the most relevant food by-products, displaying limited commercial exploitation entailing economic and environmental problems. However, these by-products present a considerable amount of dietary fiber and prebiotics with important biological activities, such as gut microbiota modulation, lowering the glycemic load and replacing some unhealthy ingredients with an impact on food texture. Therefore, the international scientific community has considered incorporating their extracts or powders to preserve or fortify food products an area of interest, mainly because nowadays consumers demand the production of safer and health-promoting foods. In the present review, literature, mainly from the last 5 years, is critically analyzed and presented. A particular focus is given to utilizing the extracted dietary fibers in different food products and their impact on their characteristics. Safety issues regarding fruits and vegetables wastes utilization and anti-nutritional compounds impact were also discussed.
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Heenan P, Creemers RH, Sharma S, Keenan J, Bayer S, Young W, Cooney J, Armstrong K, Fraser K, Skidmore PM, Talley NJ, Roy N, Gearry RB. Cohort Profile: The Christchurch IBS cOhort to investigate Mechanisms FOr gut Relief and improved Transit (COMFORT). Inflamm Intest Dis 2020; 5:132-143. [PMID: 32999886 PMCID: PMC7506285 DOI: 10.1159/000508160] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 04/23/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND AND AIMS This cross-sectional observational case-control study was initiated in July 2016 with the aim of increasing an understanding of the underlying disease mechanisms in functional gastrointestinal disorders (FGIDs) including irritable bowel syndrome (IBS), functional diarrhoea (FD), and functional constipation (FC). Specific areas of interest include the effect of food, microbiome, host and microbial genetics, metabolome, and psychological variables on unexplained chronic gastrointestinal (GI) symptoms. METHODS This study recruited consecutive patients who were attending one of two endoscopy centres in Christchurch, New Zealand, for colonoscopy and a subgroup of participants from the general public who did not undergo colonoscopy. Participants with known GI disease other than an FGID were excluded. Those with symptoms were recruited as cases, whilst those without symptoms were recruited as controls. In the days prior to preparation for colonoscopy, or an agreeable time for those not undergoing colonoscopy, demographic, symptom, psychological, dietary, and health data were collected in addition to biological samples (breath, faeces, blood, and urine). Colonic biopsies were taken at the time of colonoscopy from participants in the colonoscopy subgroup. RESULTS Between July 2016 and December 2018, 349 participants were recruited, 315 of whom completed the study, 220 participants were from the colonoscopy subgroup, and 95 from the non-colonoscopy subgroup. This included 129 controls and 186 cases (57 IBS-diarrhoea predominant, 30 IBS-constipation predominant, 41 IBS-mixed, 42 FC, and 16 FD). The mean age of FGID cases was 53.4 years and controls 54.4 years. Cases (149/186, 80.1%) and controls (57/72, 55.8%) were predominantly female. Education levels were similar across the cohort. Smoking and alcohol rates were also similar. Biological samples were collected as planned from participants. CONCLUSIONS The COMFORT cohort is a unique clinical cohort of FGID cases and controls with a wide range of demographic, dietary, clinical, psychological, and health data in addition to biological samples. Future research will aim to use a systems biology approach to establish the potential role of diet, host-microbiome interactions, and other factors in the pathogenesis of FGIDs.
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Affiliation(s)
- Phoebe Heenan
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Rob H. Creemers
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Shriya Sharma
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Jacqueline Keenan
- Department of Surgery, University of Otago, Christchurch, New Zealand
| | - Simone Bayer
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Wayne Young
- Food Nutrition and Health, Grasslands Research Centre, AgResearch, Palmerston North, New Zealand
- Riddet Institute, Massey University, Palmerston North, New Zealand
- High Value Nutrition Science Challenge, University of Newcastle, Newcastle, New South Wales, Australia
| | - Janine Cooney
- High Value Nutrition Science Challenge, University of Newcastle, Newcastle, New South Wales, Australia
- Massey University, Biological Chemistry & Bioactives Group and Food Innovation, Palmerston North, New Zealand
| | - Kelly Armstrong
- Food Nutrition and Health, Grasslands Research Centre, AgResearch, Palmerston North, New Zealand
| | - Karl Fraser
- Food Nutrition and Health, Grasslands Research Centre, AgResearch, Palmerston North, New Zealand
- Riddet Institute, Massey University, Palmerston North, New Zealand
- High Value Nutrition Science Challenge, University of Newcastle, Newcastle, New South Wales, Australia
| | - Paula M. Skidmore
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Nicholas J. Talley
- Plant & Food Research, Research and Innovation Division, Hamilton, New Zealand
| | - Nicole Roy
- Riddet Institute, Massey University, Palmerston North, New Zealand
- High Value Nutrition Science Challenge, University of Newcastle, Newcastle, New South Wales, Australia
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | - Richard B. Gearry
- Department of Medicine, University of Otago, Christchurch, New Zealand
- High Value Nutrition Science Challenge, University of Newcastle, Newcastle, New South Wales, Australia
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