Prevalence of Irritable Bowel Syndrome Among Physicians at General Governmental Hospitals in Jeddah, Saudi Arabia.

Background Irritable bowel syndrome (IBS) is a prevalent functional gastrointestinal disorder characterized by symptoms such as abdominal pain and altered bowel habits. It significantly impacts the quality of life and imposes a financial burden on healthcare systems. Previous studies have shown varying prevalence rates of IBS among different populations. Objective This study aims to determine the prevalence of IBS among physicians working in general governmental hospitals in Jeddah, Saudi Arabia, and to analyze the associated demographic and lifestyle factors. Methods An analytical cross-sectional study of 391 physicians from King Fahad and East Jeddah General Hospitals used an anonymous electronic survey covering demographics, health, lifestyle, and the Birmingham IBS Symptoms Questionnaire. Data were analyzed with SPSS version 29 (IBM Corp., Armonk, NY, USA) using Kruskal-Wallis and Mann-Whitney U tests, with p < 0.05 as significant. Results The prevalence of IBS among the participants was 45% (n=176). Significant associations were found between Birmingham scores and various demographic and lifestyle factors. Younger age groups (25-29 years, 51.4%, n=201) had higher mean ranks (212.98) compared to older age groups, with a p-value of .009. Males (54.5%, n=213) had a significantly higher mean rank (213.37) compared to females (45.5%, n=178; 175.22) (p<.001). Non-smokers (38.1%, n=149) had a significantly higher mean rank (214.27) compared to smokers (61.9%, n=242; 166.33) (p<.001). Physical exercise was associated with a lower prevalence of IBS symptoms, with non-exercisers (39.9%, n=156) having a higher mean rank (207.67) compared to exercisers (60.1%, n=235; 178.42) (p=.012). Additionally, 46.3% (n=181) of participants reported missing work due to IBS symptoms. Conclusion The study found a high prevalence of IBS among physicians in Jeddah, with significant associations between IBS symptoms and various demographic and lifestyle factors. These findings highlight the need for increased awareness, regular screening, and support for physicians suffering from IBS to improve their quality of life and job performance.

From gut to brain: unveiling probiotic effects through a neuroimaging perspective-A systematic review of randomized controlled trials.

The gut-brain axis, a bidirectional communication network between the gastrointestinal system and the brain, significantly influences mental health and behavior. Probiotics, live microorganisms conferring health benefits, have garnered attention for their potential to modulate this axis. However, their effects on brain function through gut microbiota modulation remain controversial. This systematic review examines the effects of probiotics on brain activity and functioning, focusing on randomized controlled trials using both resting-state and task-based functional magnetic resonance imaging (fMRI) methodologies. Studies investigating probiotic effects on brain activity in healthy individuals and clinical populations (i.e., major depressive disorder and irritable bowel syndrome) were identified. In healthy individuals, task-based fMRI studies indicated that probiotics modulate brain activity related to emotional regulation and cognitive processing, particularly in high-order areas such as the amygdala, precuneus, and orbitofrontal cortex. Resting-state fMRI studies revealed changes in connectivity patterns, such as increased activation in the Salience Network and reduced activity in the Default Mode Network. In clinical populations, task-based fMRI studies showed that probiotics could normalize brain function in patients with major depressive disorder and irritable bowel syndrome. Resting-state fMRI studies further suggested improved connectivity in mood-regulating networks, specifically in the subcallosal cortex, amygdala and hippocampus. Despite promising findings, methodological variability and limited sample sizes emphasize the need for rigorous, longitudinal research to clarify the beneficial effects of probiotics on the gut-brain axis and mental health.

Prevalence of IBS and its association with academic stress and dormitory lifestyle among medical students of Bangladesh: A cross-sectional study.

Introduction: Irritable Bowel Syndrome (IBS) is a chronic gastrointestinal disorder affecting a substantial portion of the global population. While the prevalence of IBS is well-documented worldwide, limited research has explored its occurrence and associated factors among medical students in Bangladesh, a population exposed to high academic stress. This cross-sectional study aimed to assess the prevalence of IBS among medical students and investigate its potential association with stress levels and the dormitory lifestyle. Methods: Data were collected from 402 medical students using a self-administered questionnaire covering sociodemographic information, academic stress, lifestyle factors, and the Rome III Criteria for diagnosing IBS. Statistical analysis included bivariate and logistic regression analyses to identify significant associations and predictors of IBS prevalence. Results: This study among 402 university students found an overall irritable bowel syndrome (IBS) prevalence of 22.88 %, with 35.87 % diarrhea-predominant, 26.08 % constipation-predominant, and 38.04 % mixed subtype. Hostel residents had 2.11 times higher adjusted odds of IBS (95 % CI: 1.05-4.25, p < 0.001) than non-residents. IBS prevalence increased from 20.25 % for <1 year to 24.24 % for 1-3 years and 29.13 % for >3 years of hostel stay. Age 23-28 years (OR = 1.86, p = 0.030), lack of senior support (OR = 2.36, p = 0.05), second study phase (OR = 2.43, p = 0.002), inadequate exercise (OR = 2.11, p = 0.036), and frequent fatty food intake (OR = 2.98, p = 0.03) increased IBS risk. Higher academic stress (OR = 2.03, p = 0.002) predicted IBS, with 54.44 % vs. 43.78 % (p = 0.035) high stress among hostel residents who exercised less (48.23 % vs. 51.77 %) and consumed more fatty foods (53.33 % vs. 46.67 %). Mediation analysis revealed dormitory living impacts stress, physical activity, and diet - established IBS risk factors. Conclusion: The high prevalence of IBS among medical students in Bangladesh highlights the need for interventions to address changeable factors like academic stress, dormitory living conditions, lack of physical activity, and unhealthy eating habits to improve their health and wellness.

Additional criteria on scintigraphic testing for diagnosis of rapid colonic transit in patients with chronic diarrhea.

BACKGROUND: Colonic transit (CT) measured by validated scintigraphy using 111In-labeled activated charcoal particles is summarized using geometric center (GC) of isotopic distribution in four colonic regions and stool at 24 and 48 h. Diagnosis of rapid CT is currently based on GC24 ≥4.4 in females and >4.7 in males, which lack sensitivity. Our aim was to evaluate, in patients with chronic diarrhea with normal CT by GC24 and GC48, the diagnostic utility of CT change (∆GC) relative to sex-matched normal values. METHODS: We evaluated two adult patient cohorts: 701 clinical patients (1994-2023) with chronic diarrhea and 76 research participants with irritable bowel syndrome with diarrhea (N = 63) or bile acid diarrhea (BAD, N = 13). Results of ∆GC were compared to 220 healthy controls' 95th percentiles (%ile) (≥2.0 females and ≥2.2 males). In the research cohort, we also analyzed (Spearman correlation) colonic ∆GC with ascending colon emptying T1/2 (AC T1/2), average stool frequency and consistency based on a daily diary, total fecal bile acid (BA) concentration, and % primary BA in a single stool sample. KEY RESULTS: Among 701 clinical patients with normal GC24, 160 (22.3%) had rapid CT based on ∆GC 95th %ile in health. Among 76 research participants, an additional 20.6% IBS-D and 23% BAD had rapid CT ∆GC. Younger age and absence of diabetes mellitus were predictive of rapid ∆GC. ∆GC significantly correlated with AC T1/2 and with fecal BA. CONCLUSIONS & INFERENCES: ∆GC identified an additional 21%-23% patients with rapid colonic transit among patients with diarrhea and normal GC24.

BPP43_05035 is a Brachyspira pilosicoli cell surface adhesin that weakens the integrity of the epithelial barrier during infection.

The anaerobic spirochete Brachyspira causes intestinal spirochetosis, characterized by the intimate attachment of bacterial cells to the colonic mucosa, potentially leading to symptoms such as diarrhea, abdominal pain, and weight loss. Despite the clinical significance of Brachyspira infections, the mechanism of the interaction between Brachyspira and the colon epithelium is not known. We characterized the molecular mechanism of the B. pilosicoli-epithelium interaction and its impact on the epithelial barrier during infection. Through a proteomics approach, we identified BPP43_05035 as a candidate B. pilosicoli surface protein that mediates bacterial attachment to cultured human colonic epithelial cells. The crystal structure of BPP43_05035 revealed a globular lipoprotein with a six-bladed beta-propeller domain. Blocking the native BPP43_05035 on B. pilosicoli, either with a specific antibody or via competitive inhibition, abrogated its binding to epithelial cells, which required cell surface-exposed N-glycans. Proximity labeling and interaction assays revealed that BPP43_05035 bound to tight junctions, thereby increasing the permeability of the epithelial monolayer. Extending our investigation to humans, we discovered a downregulation of tight junction and brush border genes in B. pilosicoli-infected patients carrying detectable levels of epithelium-bound BPP43_05035. Collectively, our findings identify BPP43_05035 as a B. pilosicoli adhesin that weakens the colonic epithelial barrier during infection.

Irritable Bowel Syndrome in the Elderly Population: A Comprehensive Review.

Irritable bowel syndrome (IBS) is a fairly common functional digestive disorder; it occurs at any age but it is more common in adults and older adults. Patients experience a series of symptoms in which abdominal pain and changes in bowel movements stand out; some studies have revealed a possible association between IBS and psychological problems, such as anxiety and depression. Recent findings point to disorders of gut-brain interaction, disruption and alteration of gut microbiota and dysbiosis as key factors in the etiopathogenesis of IBS; aging is also one the factors involved. Most patients diagnosed with IBS required pharmacotherapy, greater caution needs to be considered when treating older patients because of the risk-benefit profile in the elderly. In this scenario, probiotics and non-pharmacological treatments appear as safe and accessible options. Clinicians must take into consideration the unique biopsychosocial factors in older adults when treating IBS. We aim to review critically recent literature on the topic of IBS as there is a need for consolidated guidelines.

The causal relationship between cholecystectomy and IBD/IBS and the role of bile acids and gut microbiota: a two-sample Mendelian randomization study.

OBJECTIVE: This study aims to explore the causal relationship between cholecystectomy and inflammatory bowel disease (IBD)/irritable bowel syndrome (IBS) and the role of serum bile acids and gut microbiota in this context. METHODS: Utilizing genetic variant data from previous Genome-Wide Association Studies (GWAS), this study employed a two-sample MR approach to assess the causal effect of cholecystectomy on IBD/IBS. RESULTS: The MR analysis suggested a potential negative causal relationship between cholecystectomy and UC (p = 0.0233, OR 0.9773, 95%CI 0.9581-0.9969) and a positive causal relationship between cholecystectomy and IBS (p = 0.0395, OR 4.077, 95%CI 1.0699-15.5362). Various sensitivity analyses reinforced the reliability of the causal relationship. However, the analysis did not find definitive results between serum bile acids or gut microbiota and cholecystectomy or IBD/IBS, possibly due to insufficient statistical power. MVMR find a causal relationship between bile acids and IBS (p = 0.0015, b = 0.4085) and UC (p = 0.0198, b = 0.0029). CONCLUSION: This study provides evidence of a causal relationship between cholecystectomy and IBD/IBS, highlighting the potential risk reduction for UC and increased risk for IBS following cholecystectomy. The role of bile acids and gut microbiota in this relationship remains unclear, necessitating further research to validate the causality and explore underlying mechanisms.

Transcriptomic Module Discovery of Diarrhea-Predominant Irritable Bowel Syndrome: A Causal Network Inference Approach.

Irritable bowel syndrome with diarrhea (IBS-D) is the most prevalent subtype of IBS, characterized by chronic gastrointestinal symptoms in the absence of identifiable pathological findings. This study aims to investigate the molecular mechanisms underlying IBS-D using transcriptomic data. By employing causal network inference methods, we identify key transcriptomic modules associated with IBS-D. Utilizing data from public databases and applying advanced computational techniques, we uncover potential biomarkers and therapeutic targets. Our analysis reveals significant molecular alterations that affect cellular functions, offering new insights into the complex pathophysiology of IBS-D. These findings enhance our understanding of the disease and may foster the development of more effective treatments.

Macrophages and Gut Barrier Function: Guardians of Gastrointestinal Health in Post-Inflammatory and Post-Infection Responses.

The gut barrier is essential for protection against pathogens and maintaining homeostasis. Macrophages are key players in the immune system, are indispensable for intestinal health, and contribute to immune defense and repair mechanisms. Understanding the multifaceted roles of macrophages can provide critical insights into maintaining and restoring gastrointestinal (GI) health. This review explores the essential role of macrophages in maintaining the gut barrier function and their contribution to post-inflammatory and post-infectious responses in the gut. Macrophages significantly contribute to gut barrier integrity through epithelial repair, immune modulation, and interactions with gut microbiota. They demonstrate active plasticity by switching phenotypes to resolve inflammation, facilitate tissue repair, and regulate microbial populations following an infection or inflammation. In addition, tissue-resident (M2) and infiltration (M1) macrophages convert to each other in gut problems such as IBS and IBD via major signaling pathways mediated by NF-κB, JAK/STAT, PI3K/AKT, MAPK, Toll-like receptors, and specific microRNAs such as miR-155, miR-29, miR-146a, and miR-199, which may be good targets for new therapeutic approaches. Future research should focus on elucidating the detailed molecular mechanisms and developing personalized therapeutic approaches to fully harness the potential of macrophages to maintain and restore intestinal permeability and gut health.

The PDIA3-STAT3 protein complex regulates IBS formation and development via CTSS/MHC-II pathway-mediated intestinal inflammation.

Irritable bowel syndrome (IBS) is a persistent functional gastrointestinal disorder characterised by abdominal pain and altered patterns of defecation. This study aims to clarify an increase in the expression and interaction of protein disulfide-isomerase A3 (PDIA3) and Signal Transducer and Activator of Transcription 3 (STAT3) within the membrane of dendritic cells (DCs) from individuals with IBS. Mechanistically, the heightened interaction between PDIA3 and STAT3 at the DC membrane results in reduced translocation of phosphorylated STAT3 (p-STAT3) into the nucleus. The reduction of p-STAT3 to nuclear transport subsequently increased the levels of cathepsin S (CTSS) and major histocompatibility complex class II (MHC-II). Consequently, activated DCs promote CD4+ T cell proliferation and cytokine secretion, including interleukin-4 (IL-4), interleukin-6 (IL-6), interleukin-9 (IL-9), and tumour necrosis factor-alpha (TNF-α), thereby contributing to the development of IBS. Importantly, the downregulation of PDIA3 and the administration of punicalagin (Pun), a crucial active compound found in pomegranate peel, alleviate IBS symptoms in rats, such as increased visceral hypersensitivity and abnormal stool characteristics. Collectively, these findings highlight the involvement of the PDIA3-STAT3 protein complex in IBS, providing a novel perspective on the modulation of immune and inflammatory responses. Additionally, this research advances our understanding of the role and mechanisms of PDIA3 inhibitors, presenting new therapeutic possibilities for managing IBS.

Does irritable bowel syndrome plague our budding doctors? - A study from an Indian medical college.

BACKGROUND: Irritable bowel syndrome (IBS) is a lifestyle disease associated with significant morbidity and healthcare expenses. Although the pathophysiology of this disease remains obscure till date, there are many possible predisposing factors that have been described. Medical education is extremely demanding and taxing, with students facing multiple stressors throughout their course. Stress and mental illnesses being one of the main risk factors for IBS, these students are possibly at a much higher risk of suffering from this disease. OBJECTIVE: The objective of this article is to study the frequency of IBS among a sample of students in a medical college in India and try to determine the determinants associated with this disease. MATERIALS AND METHODS: This is a cross-sectional study conducted among students studying in Kasturba Medical College, Mangalore. A self-administered World Gastroenterology Organization (WGO) questionnaire was filled by the participants. The responses were analyzed for identifying those likely to be suffering from IBS based on a scoring system and to assess the association between risk categories and IBS. RESULTS: Prevalence of IBS among 397 participants was found to be 16.9%. About 20.8% of females suffered from IBS as against 11.4% of males. It was also found that the proportion of medical undergraduates likely to be suffering from IBS was more in those belonging to the NRI category (28.6%), those who consumed a diet which was predominantly vegetarian (19.1%) and less in those staying at home (14.5%). CONCLUSION: The proportion of students suffering from IBS was observed to be 16.9% of the sample population with a significant female gender preponderance.

Using PRECIS-2 in Chinese herbal medicine randomized controlled trials for irritable bowel syndrome: A methodological exploration based on literature.

Background: The pragmatism levels of randomized controlled trials (RCTs) mean how similar the interventions delivered in the trial setting match those in the setting where the results will be applied. We aimed to investigate the association between the consistency of pragmatism among the characteristics of RCT design and its effect size of results in Chinese herbal medicine (CHM) for irritable bowel syndrome (IBS). Methods: Eight English and Chinese language databases were searched for RCTs on CHM for IBS. Six reviewers independently assessed the pragmatism of trials using the pragmatic-explanatory continuum indicator summary 2 (PRECIS-2) tool. The consistency of pragmatism levels among the characteristics of RCT design was calculated using the coefficient of variation. Linear regression models were adopted to explore influence factors of the pragmatism of RCTs. Results: 78 RCTs were included. The level of consistency in the pragmatism for RCT's design was significantly correlated with the effect size of the results (binary outcome, r = -0.413; P = 0.005; continuous outcome, r = -0.779, P < 0.001). PRECIS-2 score was higher in trials with individualized interventions than fixed interventions (3.29 [0.32] vs 2.90 [0.32]; Cohen's d relative effect size, 0.52; P < 0.001) and in standard or usual-treatment-controlled trials than placebo-controlled (3.05 [0.37] vs 2.83 [0.28]; Cohen's d relative effect size, 0.32; P = 0.048). Conclusion: The consistency of pragmatism level across the 9 domains of the PRECIS-2 tool in CHM IBS RCTs was positively correlated with the effect size of the results.

Somatic, emotional, and gastrointestinal symptom severity are increased among children and adolescents with COVID-19.

BACKGROUND: Post-infectious disorders of gut-brain interaction (PI-DGBI) have significant impact on children and adolescents. The effect of COVID-19 on PI-DGBI-associated symptoms in this population, however, is unknown. METHODS: We performed electronic medical record searches to identify patients 8-17 years old with a SARS-CoV2 PCR test at Lurie Children's Hospital between November 2020 and March 2021 (cohort 1) and April-October 2021 (cohort 2). Questionnaires were administered to assess symptoms prior to and 3 months following the test. This included the Pediatric Eosinophilic Esophagitis Symptom Score (PEESS), questionnaire of pediatric gastrointestinal symptoms-Rome IV, Nausea Profile (NP), dyspepsia symptom survey (DSS), nausea severity profile (NSP), and Pediatric Quality of Life Inventory (PedsQL). We grouped patients based on the presence of symptoms prior to COVID-19 test or the test result. RESULTS: One hundred and ninety-six parent(s) or guardian(s) in cohort 1 and 274 in cohort 2 completed surveys and self-reported their child's COVID-19 result. Cohort 1 had increased PEESS and DSS scores, lower PedsQL scores, and increased frequency of abdominal pain disorders among patients with symptoms prior to COVID-19 testing. Both cohorts had increased NP and NSP scores among patients with symptoms prior to COVID-19 testing that was highest among patients with a positive COVID-19 test. Abdominal pain and diarrhea prior to COVID-19 testing predicted higher NP scores. CONCLUSIONS: Among symptomatic COVID-19 tested children, we found increased severity of nausea-associated somatic, emotional, and gastrointestinal symptoms in the 3 months following the test that was most increased among patients with a positive COVID-19 test.

Burden of illness and treatment attitudes among participants meeting Rome IV criteria for irritable bowel syndrome: A nationwide survey in the United States.

BACKGROUND: Irritable bowel syndrome (IBS) is a disorder of gut-brain interaction characterized by abdominal pain and altered bowel habits, with patient-perceived dissatisfaction of treatment symptom control. We assessed disease burden, satisfaction with medication use, and impact on activities, in participants with IBS with constipation (IBS-C) and diarrhea (IBS-D). METHODS: This study assessed data from a large, United States survey of adults querying demographics, comorbid conditions, quality of life, medication use, satisfaction with symptom control, and work productivity. Participants were grouped into the IBS-C or IBS-D cohort if they met Rome IV criteria, with controls matched 1:1 according to age, sex, race, region, and Charlson Comorbidity Index score. All data were self-reported. KEY RESULTS: Nine hundred and ten participants with IBS-C and 669 with IBS-D were matched to controls. The most reported symptoms were abdominal discomfort for IBS-C and abdominal pain and abdominal discomfort for IBS-D. Among the IBS-C and IBS-D cohorts, 74.2% and 65.9%, respectively, took prescription and/or over-the-counter medication for their symptoms. Respondents were more dissatisfied than satisfied with control of their symptoms. Respondents taking prescription medication(s) with or without over-the-counter medication(s) reported better symptom control than respondents only taking over-the-counter medications (p < 0.001). There was significantly higher mean presenteeism, work productivity loss, and daily activity impairment (p < 0.001 for all) in respondents with IBS compared with controls. CONCLUSIONS AND INFERENCES: This study provides insight into respondents' experiences of IBS symptoms, including the impact on daily activity, as well as satisfaction with control of symptoms and prescription and over-the-counter medications.

The effects of vitamin D intake and status on symptom severity and quality-of-life in adults with irritable bowel syndrome (IBS): a systematic review and meta-analysis.

IMPORTANCE: Many individuals with irritable bowel syndrome (IBS) have insufficient or deficient serum 25-hydroxyvitamin D [25(OH)D] status; however, it is not clear if improved vitamin D nutritional status through higher intake can improve symptom severity and quality of life. OBJECTIVE: This systematic review and meta-analysis aimed to identify if changes in vitamin D intake or status affect symptom severity and quality of life in adults with IBS.Data Sources: MEDLINE®, Cochrane Central Register of Controlled Trials, Global Health, EMBASE, and Web-of-Science databases were systematically searched for relevant articles to August 12, 2024, in the English language.Study Selection: Clinical trials, prospective observational studies, and Mendelian randomization (MR) analyses reporting the effect of vitamin D intake or status on IBS-related outcomes were included.Data Extraction and Synthesis: Article review and data extraction were conducted by 2 authors following the PRISMA guidelines. Random effects meta-analyses and the Nutrition Quality Evaluation Strengthening Tools to assess risk of bias were employed for randomized controlled trials.Main Outcome(s) and Measure(s): Primary outcomes included measures of serum 25(OH)D status, symptom severity, and quality of life. RESULTS: 12 studies from 15 articles were included (n = 7 RCTs; n = 3 single-arm interventions; n = 2 MR). Seven study populations had deficient (<20 ng/mL) and three had insufficient (21-29 ng/mL) baseline serum 25(OH)D status. RCTs measured changes in serum 25(OH)D after 6-26 wks with 3,000 IU daily to 50,000 IU bi-weekly vitamin D dosages. Meta-analyses of low risk-of-bias RCTs revealed increased 25(OH)D levels in groups treated with oral vitamin D compared to placebo (n = 5; Pooled mean difference [95% CI]: 20.33 [12.91, 27.74] ng/mL; I2 = 97.9%). Quality of life scores improved significantly in deficient populations (n = 3; 3.19 [2.14, 4.24]; I2 = 0.0%). Non-significant decreased trends in IBS symptom severity were shown across populations (n = 6: -25.89 [-55.26, 3.48]; I2 = 92.8%). CONCLUSION: Moderate level evidence indicate vitamin D supplementation may improve status in adults with IBS and quality of life in those with deficient status at baseline.

QUESTION: Do changes in vitamin D intake or status affect symptom severity and quality of life in adults with irritable bowel syndrome?FindingsIn this systematic review and meta-analysis, moderate level evidence supports vitamin D supplementation for improving serum 25-hydroxyvitamin D status in adults with IBS and for increasing quality of life scores in those with deficient status at baseline.Meaning: Vitamin D supplementation may improve quality of life in IBS patients with deficient serum 25-hydroxyvitamin D status.

Overweight and vitamin D deficiency are common in patients with irritable bowel syndrome - a cross-sectional study.

BACKGROUND: Irritable bowel syndrome (IBS) is a common disease with unknown etiology. Poor dietary intake with nutritional deficiency and overweight have been described to increase the risk of IBS. The aim of the present study was to compare weight and circulating levels of micronutrients in IBS compared with healthy controls. DESIGN: Cross-sectional study. METHODS: Patients diagnosed with IBS and healthy volunteers were recruited. Participants had to complete a dietary diary book and the questionnaires Rome IV, IBS-severity scoring system (IBS-SSS), and visual analog scale for IBS (VAS-IBS). Weight and height were measured, and blood samples were drawn. C-reactive protein (CRP), cobalamin, folate, iron, total iron-binding capacity (TIBC), and 25-hydroxy (25-OH) vitamin D were analyzed. Differences were calculated between groups and generalized linear model for regressions was adjusted for false discovery rate (FDR). RESULTS: IBS patients (n = 260) were elder than controls (n = 50) (44.00 (33.25-56.00) vs. 37.85 (30.18-45.48) years; p = 0.012). After adjustment for age, both weight (ß: 5.880; 95% CI: 1.433-10.327; p = 0.010, FDR = 0.020) and body mass index (BMI) (ß: 2.02; 95% CI: 0.68-3.36; p = 0.003, FDR = 0.012) were higher in patients. Among IBS participants, 48.1% were overweight/obese compared with 26.0% in controls (p = 0.007). Diarrhea-predominated IBS had highest weight (p < 0.001) and BMI (p = 0.077). CRP and cobalamin were higher in patients than controls (p = 0.010 vs. p = 0.007), whereas folate was highest in controls (p = 0.001). IBS patients had lower intake of vegetables (p = 0.026), dairy products (p = 0.004), and cereals (p = 0.010) compared with controls. Despite 21.5% of IBS patients were taking vitamin D supplements, 23.65% of them had vitamin D levels below 50 nmol/L, compared with 26.0% observed in the control group (p = 0.720). Vitamin D levels were lower in overweight than in normal weight IBS patients (60 (48-73) nmol/L vs. 65 (53-78) nmol/L, p = 0.022). Vitamin D correlated with cobalamin and folate but correlated inversely with TIBC and BMI. IBS patients had a high degree of gastrointestinal and extraintestinal symptoms, which were inversely associated with iron levels. Extraintestinal symptoms were associated with increased BMI. CONCLUSION: IBS patients were often overweight or obese, with low vitamin D levels. High burden of extraintestinal symptoms were associated with overweight and lower iron levels. REGISTRATION: ClinicalTrials.gov, NCT05192603 (Date of registration 11/29/2021) and NCT03306381 (Date of registration 09/18/2017), respectively.

Decoding IBS: a machine learning approach to psychological distress and gut-brain interaction.

PURPOSE: Irritable bowel syndrome (IBS) is a diagnosis defined by gastrointestinal (GI) symptoms like abdominal pain and changes associated with defecation. The condition is classified as a disorder of the gut-brain interaction (DGBI), and patients with IBS commonly experience psychological distress. The present study focuses on this distress, defined from reports of fatigue, anxiety, depression, sleep disturbances, and performance on cognitive tests. The aim was to investigate the joint contribution of these features of psychological distress in predicting IBS versus healthy controls (HCs) and to disentangle clinically meaningful subgroups of IBS patients. METHODS: IBS patients ( n = 49 ) and HCs ( n = 28 ) completed the Chalder Fatigue Scale (CFQ), the Hamilton Anxiety and Depression Scale (HADS), and the Bergen Insomnia Scale (BIS), and performed tests of memory function and attention from the Repeatable Battery Assessing Neuropsychological Symptoms (RBANS). An initial exploratory data analysis was followed by supervised (Random Forest) and unsupervised (K-means) classification procedures. RESULTS: The explorative data analysis showed that the group of IBS patients obtained significantly more severe scores than HCs on all included measures, with the strongest pairwise correlation between fatigue and a quality measure of sleep disturbances. The supervised classification model correctly predicted belongings to the IBS group in 80% of the cases in a test set of unseen data. Two methods for calculating feature importance in the test set gave mental and physical fatigue and anxiety the strongest weights. An unsupervised procedure with K = 3 showed that one cluster contained 24% of the patients and all but two HCs. In the two other clusters, their IBS members were overall more impaired, with the following differences. One of the two clusters showed more severe cognitive problems and anxiety symptoms than the other, which experienced more severe problems related to the quality of sleep and fatigue. The three clusters were not different on a severity measure of IBS and age. CONCLUSION: The results showed that psychological distress is an integral component of IBS symptomatology. The study should inspire future longitudinal studies to further dissect clinical patterns of IBS to improve the assessment and personalized treatment for this and other patient groups defined as disorders of the gut-brain interaction. The project is registered at https://classic. CLINICALTRIALS: gov/ct2/show/NCT04296552 20/05/2019.

Unplanned 30-Day Readmissions After Hospitalization for Irritable Bowel Syndrome.

Background Irritable bowel syndrome (IBS) continues to pose significant healthcare challenges due to its broad differential diagnosis and the often extensive yet inconclusive workup. We investigated the rates and characteristics of unplanned 30-day readmissions in adult patients hospitalized with IBS. In addition, we identified factors that predict readmission within 30 days of initial discharge. Methods We analyzed the 2020 Nationwide Readmission Database. Using the International Classification of Diseases, Tenth Revision, Clinical Modification code, we identified hospitalizations in adult patients with IBS. We excluded hospitalizations for minors and planned or elective readmissions. To compare baseline characteristics between readmissions and index hospitalizations, χ2 tests were employed. We used multivariate Cox regression analyses to identify independent predictors of readmissions. Results A total of 5,729 adult hospitalizations with IBS as the primary diagnosis were discharged alive, and 638 (11.1%) readmissions occurred within 30 days. The most common diagnoses associated with readmission were noninfective gastroenteritis and colitis, sepsis, enterocolitis due to Clostridium difficile, and irritable bowel syndrome with or without diarrhea. Patients in readmissions had a mean age of 56.3 years, similar to index hospitalizations (54.5 years, p=0.093). Readmissions had a higher burden of comorbidity (Charlson comorbidity index (CMI) scores ≥3: 26.7%, 170 cases vs. 16.6%, 953 cases; p<0.001) and were mostly Medicare beneficiaries (49.5%, 316% vs. 44.9%, 2,578) compared with index hospitalizations. Readmissions had a longer mean length of stay (LOS) (5.2 vs. 3.6 days, p<0.0001), higher inpatient mortality (0.8%, 5% vs. 0.2%, 11; p=0.032), and higher mean hospital costs ($47,852 vs. $34,592; p<0.0001) compared with index admissions. Secondary diagnoses of ulcerative colitis (adjusted hazard ratio (AHR), 2.82; p<0.0001), interstitial cystitis (AHR, 5.37; p=0.007), peripheral vascular disease (AHR, 1.59; p=0.027), and discharge to short-term hospitals (AHR, 1.03; p<0.0001) were significantly associated with a higher likelihood of readmission within 30 days. Conclusion IBS readmissions have poorer outcomes than index hospitalizations. Patients with an existing history of ulcerative colitis, interstitial cystitis, and peripheral vascular disease and those discharged to short-term hospitals following index hospitalization are more likely to be readmitted within 30 days.

Understanding the kynurenine pathway: A narrative review on its impact across chronic pain conditions.

Chronic pain is a debilitating symptom with a significant negative impact on the quality of life and socioeconomic status, particularly among adults and the elderly. Major Depressive Disorder (MDD) stands out as one of the most important comorbid disorders accompanying chronic pain. The kynurenine pathway serves as the primary route for tryptophan degradation and holds critical significance in various biological processes, including the regulation of neurotransmitters, immune responses, cancer development, metabolism, and inflammation. This review encompasses key research studies related to the kynurenine pathway in the context of headache, neuropathic pain, gastrointestinal disorders, fibromyalgia, chronic fatigue syndrome, and MDD. Various metabolites produced in the kynurenine pathway, such as kynurenic acid and quinolinic acid, exhibit neuroprotective and neurotoxic effects, respectively. Recent studies have highlighted the significant involvement of kynurenine and its metabolites in the pathophysiology of pain. Moreover, pharmacological interventions targeting the regulation of the kynurenine pathway have shown therapeutic promise in pain management. Understanding the underlying mechanisms of this pathway presents an opportunity for developing personalized, innovative, and non-opioid approaches to pain treatment. Therefore, this narrative review explores the role of the kynurenine pathway in various chronic pain disorders and its association with depression and chronic pain.

Detecting bioactive compound contents in Dancong tea using VNIR-SWIR hyperspectral imaging and KRR model with a refined feature wavelength method.

Hyperspectral imaging (HSI) provides opportunity for non-destructively detecting bioactive compounds contents of tea leaves and high detection accuracy require extracting effective features from the complex hyperspectral data. In this paper, we proposed a feature wavelength refinement method called interval band selecting-competitive adaptive reweighted sampling-fusing (IBS-CARS-Fusing) to extract feature wavelengths from visible-near-infrared (VNIR) and short-wave-near-infrared (SWIR) hyperspectral images. Combined with the proposed IBS-CARS-Fusing method, a kernel ridge regression (KRR) model was established to predict the contents of bioactive compounds including chlorophyll a, chlorophyll b, carotenoids, tea polyphenols, and amino acids in Dancong tea. It was revealed that the IBS-CARS-Fusing method can improve Rp2 of KRR model for these bioactive compounds by 4.77%, 4.60%, 6.74%, 15.52%, and 13.10%, respectively, and Rp2 of the model reached high values of 0.9500, 0.9481, 0.8946, 0.8882, and 0.8622. Additionally, a leaf compound mass per area thermal map was used to visualize the spatial distribution of the compounds.