Adherence to treatment of patients with irritable bowel syndrome: state of the issue

Potential role of short-chain fatty acids in irritable bowel syndrome in overweight and obese individuals

Due to increasing prevalence of functional diseases of the colon in obese patients, the mechanisms by which the intestinal microbiota affects the development of symptoms of irritable bowel syndrome (IBS) in the setting of metabolic activity of adipose tissue should be investigated. The quantitative and qualitative changes in the pool of synthesized short-chain fatty acids, which have a multidirectional impact on the colonic motility is one of the key mechanisms by which the intestinal microbiota affects the occurrence and features of the course of irritable bowel syndrome. But as regards the issue of whether individual short-chain fatty acids have an impact on the severity of abdominal pain and characteristics of colonic motility dysfunction, it remains a subject of discussions. The study of the mechanisms of impact of short-chain fatty acids on the development and progression of obesity deserves special attention. Increased serum and faecal short-chain fatty acid levels in obese patients can either be a result of changes in the intestinal microflora composition associated with special eating habits and lifestyle, or have an independent effect on the development of obesity in individuals due to intestinal microflora composition disorders that have been already developed. Due to special features of the course of irritable bowel syndrome associated with overweight and obesity, studying the intestinal microbiota composition and the short-chain fatty acids produced by it in this cohort of IBS patients is of particular interest. This publication has been prepared to describe and systematize the possible mechanisms of impact of short-chain fatty acids on the development of abdominal pain and impaired colonic motility in IBS patients with overweight and obesity. The literature search was conducted in the databases Embase, PubMed and Google Scholar using the keywords “irritable bowel syndrome”, “obesity”, “short-chain fatty acids”, “gut microbiota”.

Clinical features and food preferences in persons with irritable bowel syndrome against the background of overweight and obesity

Aim. To identify the clinical features of the course and nutritional preferences of patients with irritable bowel syndrome (IBS) against the background of overweight and obesity in order to increase the effectiveness of therapy in this cohort of patients. Materials and methods. An open cohort cross-sectional study was conducted with the inclusion of 100 patients aged 18 to 44 years (mean age 30.636.37 years) with an established diagnosis of IBS. The main group included 50 overweight or obese people with IBS (mean age 31.675.99 years, BMI 31.314.16 kg/m2), among them: 16 men and 34 women. The comparison group included 50 people with normal weight (mean age 31.946.15 years, BMI 20.451.54 kg/m2), among them: 16 men and 34 women. IBS symptoms were assessed on a 10-point scale. Assessment of other gastroenterological complaints was carried out using a 4-point scale. The severity of anxiety and depression was assessed using the Hospital Anxiety and Depression Scale. The level of specific anxiety in relation to gastrointestinal symptoms was assessed using the VSI visceral sensitivity index. To assess the quality of life, a specific questionnaire for assessing the quality of life of patients with IBS IBS-QoL and a nonspecific questionnaire for assessing the quality of life SF-36 were used. Results. IBS patients who are overweight or obese are characterized by a more severe course of the disease, more frequent formation of a mixed variant of stool disorders and a tendency to constipation, a more common clinically pronounced anxiety and depression, a more pronounced abdominal pain syndrome and a low level of quality of life, and as well as specific food preferences. Conclusion. Studies are required to identify the relationship between the clinical features of the course of IBS and food preferences in overweight and obese individuals with leading pathogenetic mechanisms in order to correct the existing standard management regimens for overweight and obese patients suffering from IBS.