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2.
Medicine (Baltimore) ; 99(19): e20067, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32384473

RESUMEN

Irritable bowel syndrome (IBS)-like symptoms tend to be common in inflammatory bowel disease (IBD) patients even during the long-standing remission phase, and quality of life (QOL) seem to reduce in IBD patients with such symptoms. Thus, the aim of this study was to define the prevalence of IBS-like symptoms in inactive IBD patients using Rome IV criteria and evaluate the effect of IBS-like symptoms on QOL.Total 137 patients with IBD (56 with ulcerative colitis (UC) and 81 with Crohn disease (CD), who had been in long-standing remission according to the clinical scoring system and 123 control participants were included. These patients completed questionnaires to evaluate IBS-like symptoms according to Rome IV criteria, and the impact of these symptoms on the QOL of inactive IBD patients was compared with and without IBS-like symptoms according to disease-specific inflammatory bowel disease questionnaire (IBDQ).Depending on our research, IBS-like symptoms were found in 32% (18/56) of patients with inactive UC, 35% (29/81) of patients with inactive CD, and 13.8% (17/123) of control participants (P < .001). The QOL seemed to be significantly lower in both inactive UC and CD patients with IBS-like symptoms than in those without such symptoms (P < .001).In conclusion, we defined that the prevalence of IBS-like symptoms in IBD patients in remission is 2 to 3 times higher than that in healthy control participants, and significantly lower IBDQ scores showed QOL was reduced in inactive IBD patients with IBS-like symptoms as compared with patients without IBS-like symptoms.


Asunto(s)
Enfermedades Inflamatorias del Intestino/complicaciones , Síndrome del Colon Irritable/epidemiología , Síndrome del Colon Irritable/etiología , Calidad de Vida , Adulto , Anciano , Femenino , Humanos , Síndrome del Colon Irritable/diagnóstico , Masculino , Persona de Mediana Edad , Prevalencia , Evaluación de Síntomas
4.
Inflamm Bowel Dis ; 26(6): 797-808, 2020 05 12.
Artículo en Inglés | MEDLINE | ID: mdl-32333601

RESUMEN

BACKGROUND: Patients with inflammatory bowel disease (IBD) have intestinal inflammation and are treated with immune-modulating medications. In the face of the coronavirus disease-19 pandemic, we do not know whether patients with IBD will be more susceptible to infection or disease. We hypothesized that the viral entry molecules angiotensin I converting enzyme 2 (ACE2) and transmembrane serine protease 2 (TMPRSS2) are expressed in the intestine. We further hypothesized that their expression could be affected by inflammation or medication usage. METHODS: We examined the expression of Ace2 and Tmprss2 by quantitative polymerase chain reacion in animal models of IBD. Publicly available data from organoids and mucosal biopsies from patients with IBD were examined for expression of ACE2 and TMPRSS2. We conducted RNA sequencing for CD11b-enriched cells and peripheral and lamina propria T-cells from well-annotated patient samples. RESULTS: ACE2 and TMPRSS2 were abundantly expressed in the ileum and colon and had high expression in intestinal epithelial cells. In animal models, inflammation led to downregulation of epithelial Ace2. Expression of ACE2 and TMPRSS2 was not increased in samples from patients with compared with those of control patients. In CD11b-enriched cells but not T-cells, the level of expression of ACE2 and TMPRSS2 in the mucosa was comparable to other functional mucosal genes and was not affected by inflammation. Anti-tumor necrosis factor drugs, vedolizumab, ustekinumab, and steroids were linked to significantly lower expression of ACE2 in CD11b-enriched cells. CONCLUSIONS: The viral entry molecules ACE2 and TMPRSS2 are expressed in the ileum and colon. Patients with IBD do not have higher expression during inflammation; medical therapy is associated with lower levels of ACE2. These data provide reassurance for patients with IBD.


Asunto(s)
Regulación de la Expresión Génica , Inmunosupresores/farmacología , Síndrome del Colon Irritable/fisiopatología , Peptidil-Dipeptidasa A/genética , Serina Endopeptidasas/genética , Adolescente , Adulto , Anciano , Animales , Betacoronavirus/metabolismo , Biopsia , Colon/efectos de los fármacos , Colon/metabolismo , Biología Computacional , Infecciones por Coronavirus/fisiopatología , Modelos Animales de Enfermedad , Femenino , Regulación de la Expresión Génica/efectos de los fármacos , Humanos , Íleon/efectos de los fármacos , Íleon/metabolismo , Inmunosupresores/uso terapéutico , Inflamación/fisiopatología , Mucosa Intestinal/metabolismo , Síndrome del Colon Irritable/tratamiento farmacológico , Masculino , Ratones , Ratones Endogámicos C57BL , Persona de Mediana Edad , Pandemias , Neumonía Viral/fisiopatología , Reacción en Cadena en Tiempo Real de la Polimerasa , Transcriptoma , Adulto Joven
6.
Medicine (Baltimore) ; 99(9): e19351, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32118774

RESUMEN

BACKGROUND: The global prevalence of irritable bowel syndrome (IBS) is estimated to be as high as 15%, and it is estimated that IBS has a prevalence of approximately 10% to 20% in Western countries. Some trials showed mesalazine (5-aminosalicylic acid [5-ASA]) might be effective for IBS, but the results still need to be confirmed. Hence, this meta-analysis is designed to assess the efficacy and safety of mesalazine for IBS in adults and children. METHODS: We conducted a comprehensive database search for randomized trials of mesalazine for IBS in PubMed, EMBASE, and the Cochrane Library. The search strategy was performed from inception to December 31, 2019, without restrictions on publication status and language. The reference lists of the included articles were also checked to identify additional studies for potential inclusion. Two reviewers will independently review all literature for inclusion and assess their risk of bias. Two reviewers will independently extract data from eligible studies based on a pre-designed standardized form. Any disagreements will be resolved by consensus. Stata SE 15.0 software will be used for data synthesis. RESULTS: This is the first meta-analysis focusing on mesalazine for the treatment of IBS. We predict it will provide high-quality synthesis on existing evidence for IBS and a relatively comprehensive reference for clinical practice and development of clinical guidelines for IBS. CONCLUSION: This protocol outlined the significance and methodological details of a systematic review of mesalazine for IBS. This ongoing meta-analysis will provide high-quality synthesis on existing evidence for IBS. REGISTRATION: The meta-analysis has been prospectively registered in PROSPERO (CRD42019147860).


Asunto(s)
Síndrome del Colon Irritable/tratamiento farmacológico , Mesalamina/uso terapéutico , Distribución de Chi-Cuadrado , Protocolos Clínicos , Humanos , Mesalamina/farmacología
8.
MMW Fortschr Med ; 162(2): 31, 2020 02.
Artículo en Alemán | MEDLINE | ID: mdl-32016719
10.
Actas esp. psiquiatr ; 48(1): 1-7, ene.-feb. 2020. tab, graf
Artículo en Español | IBECS | ID: ibc-188327

RESUMEN

INTRODUCCIÓN: Durante la última década, se ha obtenido evidencia que respalda la relación entre el microbiota intestinal y el cerebro. El envejecimiento, el estrés, la nutrición y los medicamentos pueden alterar la composición bacteriana de la microbiota intestinal. Esta condición, llamada disbiosis, se puede reparar con prebióticos, probióticos o con trasplante de microbiota fecal (TMF). El TMF es eficaz en el tratamiento de enfermedades inflamatorias intestinales (EII). La información sobre el uso del TMF en los trastornos psiquiátricos es limitada. Este estudio tiene como objetivo investigar los cambios en la severidad de la depresión, la ansiedad y la obsesión de los pacientes que recibieron TMF para el tratamiento de enfermedades inflamatorias intestinales. METODOLOGÍA: Este estudio se realizó con 10 pacientes con EII que se sometieron al TMF entre marzo y septiembre de 2017. El TMF fue realizado por un gastroenterólogo experimentado. Los pacientes completaron el Inventario de Depresión de Beck (IDB), el Listado de Síntomas Revisado (SCL-90-R) y el Inventario Obsesivo-Compulsivo de Maudsley (MOCI) antes del TMF y otra vez un mes después del TMF. RESULTADOS: Se encontraron disminuciones significativas en las puntuaciones del IDB (Z = 2.49, p = 0.013), SCL-90-R (Z = -2.09, p = 0.037) y MOCI (Z = 2.08, p = 0.037) un mes después del TMF. Aunque las puntuaciones de la subescala de ansiedad del SCL-90-R disminuyeron, esta disminución no fue estadísticamente significativa (Z = -1.55, p = 0.121). CONCLUSIONES: La severidad de la ansiedad, la depresión y la obsesión en los pacientes con EII disminuyó después del TMF. La disminución de los síntomas psiquiátricos puede deberse al efecto neuropsiquiátrico directo del TMF (efecto primario), pero también a la mejora de los síntomas gas-trointestinales (efecto secundario). Otra posibilidad es que este resultado sea independiente de estas dos hipótesis. Por lo tanto, los resultados de nuestro estudio no son suficientes para establecer una relación de causa-efecto. Para generalizar estos resultados, se necesitan más ensayos controlados aleatorizados con muestras de más pacientes con ansiedad o depresión, pero sin enfermedades físicas concomitantes


INTRODUCTION: Over the past decade, evidence that supports the relationship between intestinal microbiota and the brain has been obtained. Ageing, stress, nutrition and medi-cines can alter the composition of bacteria in the intestinal microbiota. This condition, called dysbiosis, can be repaired through prebiotics, probiotics or fecal microbiota transplantation (FMT). FMT is effective in the tratamiento of inflammatory bowel diseases (IBD). Information on FMT's use with psychiatric disorders is limited. This study aims to investigate changes in the severity of depression, anxiety and obsession of patients who received FMT for the tratamiento of inflammatory bowel diseases. METHODS: This study was conducted with 10 patients with IBD who underwent FMT between March and September 2017. FMT was performed by an experienced gastroen-terologist. The patients completed the Beck Depression In-ventory (BDI), Symptom Checklist-90-Revised (SCL-90-R) and Maudsley Obsessive Compulsive Inventory (MOCI) be-fore FMT and again at 1 month after FMT. RESULTS: Significant decreases were found in BDI (Z = 2.49, p = 0.013), SCL-90-R (Z = -2.09, p = 0.037) and MOCI (Z = 2.08, p = 0.037) scores after 1 month of FMT. Although he SCL-90-R anxiety subscale scores decreased, this de-crease was not statistically significant (Z = -1.55, p = 0.121). CONCLUSIONS: The severity of anxiety, depression and obsession in IBD patients decreased after FMT. The decrease in psychiatric symptoms may result from the direct neuro-psychiatric effect of FMT (primary effect), but also the im-provement of gastrointestinal symptoms (secondary effect). Another possibility is that this result is independent of these two conditions. Therefore, the results of our study are not sufficient to establish a cause-effect relationship. More ran-domised controlled trials with larger samples from patients with anxiety or depression but without comorbid physical illnesses are needed to generalise these results


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Trastornos de Ansiedad/psicología , Síndrome del Colon Irritable/terapia , Estreñimiento/terapia , Diarrea/terapia , Trasplante de Microbiota Fecal/enfermería , Heces/microbiología , Síndrome del Colon Irritable/psicología , Estreñimiento/psicología , Diarrea/psicología , Enfermedades Gastrointestinales , Microbioma Gastrointestinal
11.
Eur J Clin Invest ; 50(3): e13201, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31960952

RESUMEN

BACKGROUND: Irritable bowel syndrome (IBS) is a common gastrointestinal disorder, which still lacks effective therapy. We aimed to investigate the effects of a novel formulation of Bifidobacterium longum BB536 and Lactobacillus rhamnosus HN001 with vitamin B6 (LBB) on symptoms, intestinal permeability, cultivable bacteria and metabolome in IBS subjects. MATERIALS AND METHODS: Twenty-five IBS patients (Rome IV criteria) (M:F = 8:17; age 48 years ± 11 SD) were randomized to treatment (LBB) or placebo (one month each) in a crossover randomized double-blind controlled trial. Symptoms, intestinal habits, disease severity, intestinal permeability and intestinal microbiota were analysed at 0, 30, 45 and 60 days. RESULTS: Percentage decrease from baseline of abdominal pain (-48.8% vs -3.5%), bloating (-36.35% vs +7.35%) and severity of disease (-30.1% vs -0.4%) was significantly (P < .0001) greater with LBB than placebo, respectively. In IBS-D patients, the improvement from baseline of Bristol score was more consistent with LBB (from 6 ± 0.4 to 4.3 ± 1.1, P < .00001) than placebo (from 6.2 ± 0.7 to 5.3 ± 1.1, P = .04). In IBS-C patients, Bristol score tended to improve from baseline after LBB (2.6 ± 1.1 vs 3.2 ± 0.5, P = .06). LBB significantly improved the percentage of sucralose recovery (colonic permeability) (1.86 ± 0.1 vs 1.1 ± 0.2, P = .01). During treatment, presumptive lactic acid bacteria and bifidobacteria, relative abundance of propanoic, butanoic, pentanoic acids and hydrocarbons increased, while phenol decreased. CONCLUSIONS: The novel formulation of B. longum BB536 and L. rhamnosus HN001 with B6 vitamin improves symptoms and severity of disease, restores intestinal permeability and gut microbiota in IBS patients.


Asunto(s)
Bifidobacterium longum , Síndrome del Colon Irritable/terapia , Lactobacillus rhamnosus , Adulto , Método Doble Ciego , Femenino , Microbioma Gastrointestinal , Humanos , Síndrome del Colon Irritable/microbiología , Masculino , Metaboloma , Persona de Mediana Edad
12.
Am J Gastroenterol ; 115(2): 294-301, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31913193

RESUMEN

INTRODUCTION: Abdominal pain is a cardinal feature of irritable bowel syndrome (IBS); however, differences in abdominal pain among IBS subtypes remain unknown. We aimed to characterize abdominal pain symptoms among established IBS subtypes using data from the National Gastrointestinal (GI) Survey. METHODS: Individuals participating in the National GI Survey completed National Institutes of Health GI Patient-Reported Outcomes Measurement Information System (GI-PROMIS) questionnaires. Adults meeting modified Rome III IBS criteria and reporting abdominal pain in the previous 7 days were eligible. Outcomes included abdominal pain severity, bothersomeness, interference with daily activities, frequency, and location. Results were stratified by subtype (diarrhea [IBS-D], constipation [IBS-C], and mixed [IBS-M]). Regression models adjusted for demographics and comorbidities. RESULTS: One thousand one hundred fifty-eight individuals (245 IBS-D, 232 IBS-C, and 681 IBS-M) with active IBS symptoms (defined as abdominal pain in the past 7 days) were included. Demographics were similar among the subtypes except for age, race/ethnicity, education, and marital status. The GI-PROMIS score was lower for IBS-D (percentile score of 68.6, SD = 25.1; P = 0.001) and IBS-M (69.1, SD = 25.1; P < 0.001) compared with IBS-C (75.5, SD = 20.7). Abdominal pain was more bothersome (P = 0.001), caused more interference with daily activities (P = 0.03), and was more frequent (P = 0.047) for individuals with IBS-C compared with individuals with IBS-D. No differences in these domains were seen between individuals with IBS-D and IBS-M. Individuals with IBS-C and IBS-M had more widespread pain compared with those with IBS-D. DISCUSSION: In this population-based study, we found that abdominal pain characteristics differ between the IBS subtypes. Namely, individuals with IBS-C experience more bothersome, frequent, and diffuse abdominal pain compared with those with IBS-D.


Asunto(s)
Dolor Abdominal/fisiopatología , Estreñimiento/fisiopatología , Diarrea/fisiopatología , Síndrome del Colon Irritable/fisiopatología , Dolor Abdominal/etiología , Adolescente , Adulto , Anciano , Estreñimiento/etiología , Diarrea/etiología , Femenino , Humanos , Síndrome del Colon Irritable/complicaciones , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Adulto Joven
13.
Am J Gastroenterol ; 115(2): 190-201, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31913194

RESUMEN

INTRODUCTION: We conducted a systematic review and meta-analysis to compare the prevalence of small intestinal bacterial overgrowth (SIBO) in patients with irritable bowel syndrome (IBS) and controls. METHODS: Electronic databases were searched up to December 2018 for studies reporting SIBO prevalence in patients with IBS. Prevalence rates, odds ratios (ORs), and 95% confidence intervals (CIs) of SIBO in patients with IBS and controls were calculated. RESULTS: We included 25 studies with 3,192 patients with IBS and 3,320 controls. SIBO prevalence in patients with IBS was significantly increased compared with controls (OR = 3.7, 95% CI 2.3-6.0). In studies using only healthy controls, the OR for SIBO in patients with IBS was 4.9 (95% CI 2.8-8.6). With breath testing, SIBO prevalence in patients with IBS was 35.5% (95% CI 33.6-37.4) vs 29.7% (95% CI 27.6-31.8) in controls. Culture-based studies yielded a SIBO prevalence of 13.9% (95% CI 11.5-16.4) in patients with IBS and 5.0% (95% CI 3.9-6.2) in controls with a cutoff value of 10 colony-forming units per milliliter vs 33.5% (95% CI 30.1-36.9) in patients with IBS and 8.2% (95% CI 6.8-9.6) in controls with a cutoff value of 10 colony-forming unit per milliliter, respectively. SIBO prevalence diagnosed by lactulose breath test is much greater in both patients with IBS (3.6-fold) and controls (7.6-fold) compared with glucose breath test. Similar difference is seen when lactulose breath test is compared with culture methods. OR for SIBO in patients with IBS-diarrhea compared with IBS-constipation was 1.86 (95% CI 1.83-2.8). Methane-positive breath tests were significantly more prevalent in IBS-constipation compared with IBS-diarrhea (OR = 2.3, 95% CI 1.2-4.2). In patients with IBS, proton pump inhibitor was not associated with SIBO (OR = 0.8, 95% CI 0.5-1.5, P = 0.55). DISCUSSION: This systematic review and meta-analysis suggests a link between IBS and SIBO. However, the overall quality of the evidence is low. This is mainly due to substantial "clinical heterogeneity" due to lack of uniform selection criteria for cases and controls and limited sensitivity and specificity of the available diagnostic tests.


Asunto(s)
Síndrome del Asa Ciega/epidemiología , Intestino Delgado , Síndrome del Colon Irritable/epidemiología , Antibacterianos/uso terapéutico , Síndrome del Asa Ciega/diagnóstico , Síndrome del Asa Ciega/tratamiento farmacológico , Pruebas Respiratorias , Estudios de Casos y Controles , Humanos , Prevalencia
14.
Am J Gastroenterol ; 115(2): 281-293, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31934897

RESUMEN

OBJECTIVES: Tenapanor is a first-in-class, minimally absorbed, small-molecule inhibitor of the gastrointestinal sodium/hydrogen exchanger isoform 3. This phase 3 trial assessed the efficacy and safety of tenapanor 50 mg b.i.d. for the treatment of patients with constipation-predominant irritable bowel syndrome (IBS-C). METHODS: In this phase 3, double-blind study (ClinicalTrials.gov identifier NCT02621892), patients with IBS-C were randomized to tenapanor 50 mg b.i.d. or placebo b.i.d. for 12 weeks followed by a 4-week randomized withdrawal period. The primary efficacy variable was the proportion of patients who reported a reduction in average weekly worst abdominal pain of ≥30.0% and an increase of ≥1 complete spontaneous bowel movement from baseline, both in the same week, for ≥6 weeks of the 12-week treatment period. RESULTS: Of the 629 randomized patients with IBS-C, 606 (96.3%) were included in the intention-to-treat analysis set (tenapanor: n = 307; placebo: n = 299) and 533 (84.7%) completed the 12-week treatment period. In the intention-to-treat analysis set (mean age 45 years, 81.4% women), a significantly greater proportion of patients treated with tenapanor met the primary endpoint than patients treated with placebo (27.0% vs 18.7%, P = 0.020). Abdominal symptoms and global symptoms of IBS also improved with tenapanor (P < 0.05 vs placebo). Diarrhea was the most commonly reported adverse event, resulting in study drug discontinuation in 6.5% and 0.7% of patients receiving tenapanor and placebo, respectively, during the 12-week treatment period. DISCUSSION: Tenapanor 50 mg b.i.d. improved IBS-C symptoms and was generally well tolerated, offering a potential new treatment option for patients with IBS-C.


Asunto(s)
Estreñimiento/tratamiento farmacológico , Síndrome del Colon Irritable/tratamiento farmacológico , Isoquinolinas/uso terapéutico , Sulfonamidas/uso terapéutico , Dolor Abdominal/etiología , Dolor Abdominal/fisiopatología , Adulto , Estreñimiento/etiología , Estreñimiento/fisiopatología , Deprescripciones , Diarrea/inducido químicamente , Método Doble Ciego , Femenino , Humanos , Síndrome del Colon Irritable/complicaciones , Síndrome del Colon Irritable/fisiopatología , Masculino , Persona de Mediana Edad , Intercambiador 3 de Sodio-Hidrógeno/antagonistas & inhibidores , Resultado del Tratamiento
16.
PLoS One ; 15(1): e0228205, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31978193

RESUMEN

BACKGROUND AND AIM: No previous study examined the association between whole-day water intake and odds of irritable bowel syndrome (IBS). We examined the association between whole-day water intake and odds of IBS in a large sample of Iranian adults. METHODS: This cross-sectional study was conducted among 4763 adults in Isfahan, Iran. Daily water intake was assessed using a pre-tested questionnaire by asking questions about the average number of glasses of water consumed in a day. IBS was assessed and defined using a modified Persian version of Rome III questionnaire. RESULTS: After taking potential confounders into account, no significant association between water consumption and odds of IBS was seen (OR: 1.14; 95% CI: 0.74-1.78). We observed that participants who were taking >8 glasses/d of water had greater odds of IBS-M in comparison to those who consumed <2 glasses daily (OR: 2.07; 95% CI: 1.01-4.22). No significant association was observed between water intake and odds of IBS in either gender as well [for men: OR: 1.15; 95% CI: 0.59-2.24 and for women: OR: 1.15; 95% CI: 0.62-2.12]. By BMI status, no significant association was observed between whole day water intake and odds of IBS among normal weight (BMI<25 kg/m2) or overweight and obese people (BMI≥25 kg/m2). CONCLUSION: We found that whole-day water intake was not associated with odds of IBS. A significant association between consumption of >8 glasses of water per day and odds of IBS-M was observed.


Asunto(s)
Ingestión de Líquidos , Síndrome del Colon Irritable/diagnóstico , Adulto , Índice de Masa Corporal , Estudios Transversales , Femenino , Humanos , Irán/epidemiología , Síndrome del Colon Irritable/epidemiología , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Prevalencia
17.
Nat Commun ; 11(1): 362, 2020 01 17.
Artículo en Inglés | MEDLINE | ID: mdl-31953381

RESUMEN

The human gut microbiota has now been associated with drug responses and efficacy, while chemical compounds present in these drugs can also impact the gut bacteria. However, drug-microbe interactions are still understudied in the clinical context, where polypharmacy and comorbidities co-occur. Here, we report relations between commonly used drugs and the gut microbiome. We performed metagenomics sequencing of faecal samples from a population cohort and two gastrointestinal disease cohorts. Differences between users and non-users were analysed per cohort, followed by a meta-analysis. While 19 of 41 drugs are found to be associated with microbial features, when controlling for the use of multiple medications, proton-pump inhibitors, metformin, antibiotics and laxatives show the strongest associations with the microbiome. We here provide evidence for extensive changes in taxonomy, metabolic potential and resistome in relation to commonly used drugs. This paves the way for future studies and has implications for current microbiome studies by demonstrating the need to correct for multiple drug use.


Asunto(s)
Bacterias/clasificación , Bacterias/efectos de los fármacos , Bacterias/metabolismo , Microbioma Gastrointestinal/efectos de los fármacos , Microbioma Gastrointestinal/fisiología , Metagenómica , Adulto , Antibacterianos/farmacología , Antidepresivos/farmacología , Índice de Masa Corporal , Estudios de Casos y Controles , Estudios de Cohortes , Biología Computacional , Ecosistema , Heces/microbiología , Femenino , Humanos , Síndrome del Colon Irritable/tratamiento farmacológico , Síndrome del Colon Irritable/microbiología , Laxativos/farmacología , Masculino , Metformina/farmacología , Interacciones Microbianas/efectos de los fármacos , Persona de Mediana Edad , Inhibidores de la Bomba de Protones/farmacología
18.
Med J Aust ; 212(3): 126-131, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31909482

RESUMEN

OBJECTIVES: To determine the incidence of self-reported non-coeliac wheat sensitivity (SR-NCWS) and factors associated with its onset and resolution; to describe the prevalence of factors associated with gluten avoidance. DESIGN: Longitudinal cohort study; analysis of responses to self-administered validated questionnaires (Digestive Health and Wellbeing surveys, 2015 and 2018). SETTING, PARTICIPANTS: Subset of an adult population sample randomly selected in 2015 from the electoral rolls for the Newcastle and Gosford regions of New South Wales. MAIN OUTCOME MEASURES: Prevalence of SR-NCWS (2015, 2018) and incidence and resolution of SR-NCWS, each by demographic and medical factors; prevalence of gluten avoidance and reasons for gluten avoidance (2018). RESULTS: 1322 of 2185 eligible participants completed the 2018 survey (response rate, 60.5%). The prevalence of SR-NCWS was similar in 2015 (13.8%; 95% CI, 12.0-15.8%) and 2018 (13.9%; 95% CI, 12.1-15.9%); 69 of 1301 respondents (5.3%) reported developing new onset (incident) SR-NCWS between 2015 and 2018 (incidence, 1.8% per year). Incident SR-NCWS was significantly associated with a diagnosis of functional dyspepsia, and negatively associated with being male or older. Gluten avoidance was reported in 2018 by 24.2% of respondents (20.5% partial, 3.8% complete avoidance); general health was the most frequent reason for avoidance (168 of 316 avoiders, 53%). All 13 participants with coeliac disease, 56 of 138 with irritable bowel syndrome (41%), and 69 of 237 with functional dyspepsia (29%) avoided dietary gluten. CONCLUSIONS: The prevalence of SR-NCWS was similar in 2015 and 2018. Baseline (2015) and incident SR-NCWS (2018) were each associated with functional gastrointestinal disorders. The number of people avoiding dietary gluten exceeds that of people with coeliac disease or SR-NCWS, and general health considerations and abdominal symptoms are the most frequently reported reasons for avoidance.


Asunto(s)
Enfermedad Celíaca/epidemiología , Autoinforme , Hipersensibilidad al Trigo/epidemiología , Adulto , Anciano , Enfermedad Celíaca/dietoterapia , Dieta Sin Gluten , Dispepsia/epidemiología , Femenino , Glútenes/administración & dosificación , Humanos , Incidencia , Síndrome del Colon Irritable/epidemiología , Modelos Logísticos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Nueva Gales del Sur/epidemiología , Prevalencia , Hipersensibilidad al Trigo/dietoterapia
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