An evidence-based update on the diagnosis and management of irritable bowel syndrome

Expert Review of Gastroenterology & Hepatology, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 16

Published: Jan. 21, 2025

Irritable bowel syndrome (IBS) is a disorder of gut-brain interaction affecting 5% the population. The cardinal symptoms are abdominal pain and altered stool form or frequency. Diagnosis management IBS. We searched literature for diagnostic accuracy studies, randomized controlled trials, meta-analyses. A positive diagnosis IBS, alongside testing to exclude celiac disease, recommended. Exhaustive investigation has low yield. Patients should be offered traditional dietary advice. If response incomplete, specialist dietetic guidance considered. Probiotics may beneficial, but quality evidence poor. First-line treatment constipation with laxatives, secretagogues used where these ineffective. Anti-diarrheal drugs first-line diarrhea, second-line including 5-hydroxytryptamine-3 antagonists, eluxadoline, rifaximin, available. antispasmodics, neuromodulators prescribed second-line. Low-dose tricyclic antidepressants, such as amitriptyline, preferred. Brain-gut behavioral therapies effective have efficacy in patients refractory standard therapies. Despite substantial advances, there remains scope improvement terms both Reinforcement strategies condition novel paradigms required.

Language: Английский

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Microbial Influences on Irritable Bowel Syndrome

Gastroenterology Clinics of North America, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 1, 2025

Language: Английский

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Sobrecrecimiento bacteriano intestinal: Mitos y realidades

Atención Primaria, Journal Year: 2025, Volume and Issue: 57(4), P. 103201 - 103201

Published: Jan. 11, 2025

Language: Английский

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Impact of Microbiota on Irritable Bowel Syndrome Pathogenesis and Management: A Narrative Review

Medicina, Journal Year: 2025, Volume and Issue: 61(1), P. 109 - 109

Published: Jan. 13, 2025

Irritable bowel syndrome (IBS) is a prevalent gastrointestinal disorder, affecting 3–5% of the global population and significantly impacting patients’ quality life healthcare resources. Alongside physical symptoms such as abdominal pain altered habits, many individuals experience psychological comorbidities, including anxiety depression. Recent research has highlighted critical role gut microbiota in IBS, with dysbiosis, characterized by an imbalance microbial diversity, frequently observed patients. The gut–brain axis, bidirectional communication network between central nervous system, plays development IBS symptoms. Although interventions probiotics, prebiotics, synbiotics, fecal transplantation (FMT) have demonstrated potential modulating alleviating symptoms, their efficacy remains area ongoing investigation. This review examines interactions microbiota, immune brain, emphasizing need for personalized therapeutic strategies. Future should aim to identify reliable microbiota-based biomarkers refine microbiome-targeted therapies enhance patient outcomes.

Language: Английский

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Usefulness of a Digital Tool to Improve Methodology and Reporting of Breath Tests for Small Intestinal Bacterial Overgrowth

Journal of Clinical Gastroenterology, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 27, 2025

Goals: We aimed to determine if the use of a web-based digital tool could improve methodology and reporting breath tests (BT). Background: Although BT represent noninvasive low-cost for diagnosis small intestinal bacterial overgrowth (SIBO), lack standardization poor test performance have been described. Methods: performed retrospective analysis consecutive series reports from 8 different gastroenterology units during period April 2024 July 2024. Data was extracted, masked, uploaded in that supports entire process creates report. Three experts SIBO who were blinded interpretation determined each patient delineated total 12 quality items considered relevant be included The main outcomes study accuracy (ie, proportion correct diagnoses) reports. Results: A 210 analyzed; type substrate informed 187 (89.0%) lactulose used most studies (162/187, 86.6%). Most measured only hydrogen (89.5%) 38 (18.1%) extended <90 minutes. diagnosed 92 (43.8%) 79 (37.6%) patients original report report, respectively. As compared with by expert gastroenterologists current guidelines, accurate 182 (86.6%) (100%) ( P <0.0001). Regarding reporting, had median 5 (3 8) described 9 (7 11) Conclusions: Breath are heterogenous do not comply guidelines. specifically developed assist appears

Language: Английский

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Nanomaterial Innovations and Machine Learning in Gas Sensing Technologies for Real-Time Health Diagnostics

ACS Sensors, Journal Year: 2025, Volume and Issue: unknown

Published: March 10, 2025

Breath sensors represent a frontier in noninvasive diagnostics, leveraging the detection of volatile organic compounds (VOCs) exhaled breath for real-time health monitoring. This review highlights recent advancements breath-sensing technologies, with focus on innovative materials driving their enhanced sensitivity and selectivity. Polymers, carbon-based like graphene carbon nanotubes, metal oxides such as ZnO SnO2 have demonstrated significant potential detecting biomarkers related to diseases including diabetes, liver/kidney dysfunction, asthma, gut health. The structural operational principles these are examined, revealing how unique properties contribute key respiratory gases acetone, ammonia (NH3), hydrogen sulfide, nitric oxide. complexity samples is addressed through integration machine learning (ML) algorithms, convolutional neural networks (CNNs) support vector machines (SVMs), which optimize data interpretation diagnostic accuracy. In addition sensing VOCs, devices capable monitoring parameters airflow, temperature, humidity, essential comprehensive analysis. also explores expanding role artificial intelligence (AI) transforming wearable into sophisticated tools personalized enabling disease Together, advances sensor ML-based analytics present promising platform future individualized, healthcare.

Language: Английский

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European Consensus on Malabsorption—UEG & SIGE, LGA, SPG, SRGH, CGS, ESPCG, EAGEN, ESPEN, and ESPGHAN. Part 1: Definitions, Clinical Phenotypes, and Diagnostic Testing for Malabsorption

United European Gastroenterology Journal, Journal Year: 2025, Volume and Issue: unknown

Published: March 25, 2025

Malabsorption is a complex and multifaceted condition characterised by the defective passage of nutrients into blood lymphatic streams. Several congenital or acquired disorders may cause either selective global malabsorption in both children adults, such as cystic fibrosis, exocrine pancreatic insufficiency (EPI), coeliac disease (CD) other enteropathies, lactase deficiency, small intestinal bacterial overgrowth (SIBO), autoimmune atrophic gastritis, Crohn's disease, gastric bowel resections. Early recognition key for tailoring proper diagnostic work-up identifying malabsorption. A patient's medical pharmacological history essential risk factors. examinations endoscopy with biopsies, non-invasive functional tests radiological imaging are useful diagnosing Because its high prevalence, CD should always be looked cases no obvious explanations high-risk individuals. Nutritional support management patients malabsorption; different options available, including oral supplements, enteral parenteral nutrition. In short syndrome, teduglutide proved effective reducing need nutrition, thus improving quality life these patients. Primary care physicians play central role early detection involved multidisciplinary teams overall this European consensus, involving ten scientific societies several experts, we have dissected all issues around malabsorption, definitions testing (Part 1), categories special populations, nutritional assessment management, primary perspective 2).

Language: Английский

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Should We Treat SIBO Patients? Impact on Quality of Life and Response to Comprehensive Treatment: A Real-World Clinical Practice Study

Nutrients, Journal Year: 2025, Volume and Issue: 17(7), P. 1251 - 1251

Published: April 3, 2025

Background: Small intestinal bacterial overgrowth (SIBO) is a dysbiosis marked by an excessive proliferation of bacteria in the small intestine, resulting abdominal symptoms that significantly affect patients' quality life. Objectives: This study aims to evaluate impact comprehensive therapeutic approach improving life patients with SIBO. Methods: For this purpose, standardized questionnaires were used at baseline, 30 days and 90 days, including IBS-QOL (Irritable Bowel Syndrome Quality Life Questionnaire), GSRS (Gastrointestinal Symptom Rating Scale), EuroQOL-5D, Bristol Scale. Results: The results show approach, combining pharmacological treatment, appropriate dietary intervention, strategies aimed gut microbiota permeability, produces sustained improvement significant proportion who participated study. Furthermore, suggest that, although gas normalization relevant indicator, clinical depend considerably on subjective perception their health. Conclusions: finding underscores importance recognizing SIBO as prevalent condition requires accurate diagnoses individualized treatments improve well-being.

Language: Английский

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Demystifying Carbohydrate Maldigestion: A Clinical Review

The American Journal of Gastroenterology, Journal Year: 2025, Volume and Issue: 120(4S), P. 1 - 11

Published: April 1, 2025

Carbohydrate intolerance is a poorly understood and potentially overlooked cause of unexplained gastrointestinal symptoms, particularly among patients with disorders gut-brain interaction. Symptoms related to carbohydrate arise from bacterial fermentation unabsorbed carbohydrates leading increased gases osmotic load within the tract. This mechanism shared across various carbohydrates, including lactose, sucrose, maltose, fructose, fermentable oligosaccharides, disaccharides, monosaccharides, polyols. Primary forms maldigestion typically affect one specific type result inherited defects in brush-border enzymes or transport mechanisms, whereas secondary, acquired, can conditions that structural integrity function pancreas small intestine. Although confirmation disaccharidase deficiency does not imply clinical relevance, obtaining careful patient history appropriate use breath testing, duodenal assay, response dietary modification help identify whose symptoms are associated who may benefit treatment. Dietary remains cornerstone therapy for should focus on determining most liberal diet allows symptom control. Given complexity time-consuming nature this process, clinicians encouraged engage dietitians expertise treatment interaction where available. Enzyme replacement also be an important adjunct management, sacrosidase improving sucrase-isomaltase helping liberalize their diet.

Language: Английский

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Common misconceptions and controversies in the management of irritable bowel syndrome

Nature Reviews Gastroenterology & Hepatology, Journal Year: 2025, Volume and Issue: unknown

Published: April 25, 2025

Language: Английский

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