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  1. Hutson JM, Hynes MC, Kearsey I, Yik YI, Veysey DM, Tudball CF, et al.
    Pediatr Surg Int, 2020 Jan;36(1):11-19.
    PMID: 31673760 DOI: 10.1007/s00383-019-04587-x
    Children with chronic idiopathic constipation (CIC) often end up at the surgeon when medical treatments have failed. This opinion piece discusses a recently described pattern of CIC called 'Rapid transit constipation (RTC)' first identified in 2011 as part of surgical workup. RTC was identified using a nuclear medicine gastrointestinal transit study (NMGIT or nuclear transit study) to determine the site of slowing within the bowel and to inform surgical treatment. Unexpectedly, we found that RTC occured in 29% of 1000 transit studies in a retrospective audit. Irritable bowel syndrome (IBS) occurs in 7-21% of the population, with a higher prevalence in young children and with constipation type dominating in the young. While 60% improve with time, 40% continue with symptoms. First-line therapy for IBS in adults is a diet low in fermentable oligosaccharides, disaccharides, monosaccharides and polyols which reduces symptoms in > 70% of patients. In children with functional gastrointestinal disorders, fructose intolerance occurs in 35-55%. Reducing fructose produced significant improvement in 77-82% of intolerant patients. In children with RTC and a positive breath test upon fructose challenge, we found that exclusion of fructose significantly improved constipation, abdominal pain, stool consistency and decreased laxative use. We hypothesise that positive breath tests and improvement of pain and bowel frequency with sugar exclusion diets in RTC suggest these children have IBS-C. These observations raise the possibility that many children with CIC could be treated by reducing fructose early in their diet and this might prevent the development of IBS in later life.
    Matched MeSH terms: Irritable Bowel Syndrome/prevention & control*
  2. Helvaci MR, Kaya H, Algin MC, Yalcin A
    Med J Malaysia, 2008 Jun;63(2):140-2.
    PMID: 18942301
    When specifically asked, about one third of people report recurrent upper abdominal discomfort, and irritable bowel syndrome (IBS) and chronic gastritis (CG) maybe the most frequently diagnosed ones among all. Consecutive patients with upper abdominal discomfort applying to the Internal Medicine Polyclinic were included into the study. IBS was diagnosed according to Rome II criteria and CG was diagnosed histologically. All cases with IBS were compared with the age and sex-matched randomly selected cases without IBS. One hundred and fifty-six patients with IBS and 179 patients without IBS were studied. CG was detected in 72.4% (113 cases) of cases with IBS, and only 36.3% (65 cases) in patients without IBS (p < 0.001). IBS probably is a cascade of many physiological events, being initiated by infection, inflammation, psychological disturbances-like many stresses and eventually leading to dysfunctions of gut and other systems of the body via a low-grade inflammatory process. CG may be one of the terminating points of the physiological events' cascade, IBS. This may explain the high prevalence of IBS in society. Keeping in mind this association will be helpful during prevention, treatment, and follow up of these common pathologies in Primary Health Centers and Internal Medicine and Gastroenterology Polyclinics for physicians.
    Matched MeSH terms: Irritable Bowel Syndrome/complications; Irritable Bowel Syndrome/physiopathology*
  3. Hartono JL, Mahadeva S, Goh KL
    J Dig Dis, 2012 May;13(5):252-7.
    PMID: 22500787 DOI: 10.1111/j.1751-2980.2012.00581.x
    To examine the differences in the prevalence and severity of anxiety and depression in patients with functional dyspepsia (FD), nonerosive reflux disease (NERD), irritable bowel syndrome (IBS) and healthy controls.
    Matched MeSH terms: Irritable Bowel Syndrome/psychology*
  4. Ghoshal UC, Sachdeva S, Ghoshal U, Misra A, Puri AS, Pratap N, et al.
    Indian J Gastroenterol, 2022 Oct;41(5):483-507.
    PMID: 36214973 DOI: 10.1007/s12664-022-01292-x
    In the clinical setting, small intestinal bacterial overgrowth (SIBO) is a frequent, but under-diagnosed entity. SIBO is linked to various gastrointestinal (GI) and non-GI disorders with potentially significant morbidity. The optimal management of SIBO is undefined while there is a lack of published consensus guidelines. Against this background, under the auspices of the Indian Neurogastroenterology and Motility Association (INMA), formerly known as the Indian Motility and Functional Diseases Association (IMFDA), experts from the Asian-Pacific region with extensive research and clinical experience in the field of gut dysbiosis including SIBO developed this evidence-based practice guideline for the management of SIBO utilizing a modified Delphi process based upon 37 consensus statements, involving an electronic voting process as well as face-to-face meetings and review of relevant supporting literature. These statements include 6 statements on definition and epidemiology; 11 on etiopathogenesis and pathophysiology; 5 on clinical manifestations, differential diagnosis, and predictors; and 15 on investigations and treatment. When the proportion of those who voted either to accept completely or with minor reservations was 80% or higher, the statement was regarded as accepted. The members of the consensus team consider that this guideline would be valuable to inform clinical practice, teaching, and research on SIBO in the Asian-Pacific region as well as in other countries.
    Matched MeSH terms: Irritable Bowel Syndrome*
  5. Ma ZF, Yusof N, Hamid N, Lawenko RM, Mohammad WMZW, Liong MT, et al.
    Benef Microbes, 2019 Mar 13;10(2):111-120.
    PMID: 30525951 DOI: 10.3920/BM2018.0008
    Individuals in a community who developed irritable bowel syndrome (IBS) after major floods have significant mental health impairment. We aimed to determine if Bifidobacterium infantis M-63 was effective in improving symptoms, psychology and quality of life measures in flood-affected individuals with IBS and if the improvement was mediated by gut microbiota changes. Design was non-randomised, open-label, controlled before-and-after. Of 53 participants, 20 with IBS were given B. infantis M-63 (1×109 cfu/sachet/day) for three months and 33 were controls. IBS symptom severity scale, hospital anxiety and depression scale, SF-36 Questionnaire, hydrogen breath testing for small intestinal bacterial overgrowth and stools for 16S rRNA metagenomic analysis were performed before and after intervention. 11 of 20 who were given probiotics (M-63) and 20 of 33 controls completed study as per-protocol. Mental well-being was improved with M-63 vs controls for full analysis (P=0.03) and per-protocol (P=0.01) populations. Within-group differences were observed for anxiety and bodily pain (both P=0.04) in the M-63 per-protocol population. Lower ratio of Firmicutes/Bacteroidetes was observed with M-63 vs controls (P=0.01) and the lower ratio was correlated with higher post-intervention mental score (P=0.04). B. infantis M-63 is probably effective in improving mental health of victims who developed IBS after floods and this is maybe due to restoration of microbial balance and the gut-brain axis. However, our conclusion must be interpreted within the context of limited sample size. The study was retrospectively registered on 12 October 2017 and the Trial Registration Number (TRN) was NCT03318614.
    Matched MeSH terms: Irritable Bowel Syndrome/complications*
  6. Ragavan ND, Kumar S, Chye TT, Mahadeva S, Shiaw-Hooi H
    PLoS One, 2015;10(9):e0121173.
    PMID: 26375823 DOI: 10.1371/journal.pone.0121173
    Blastocystis is one of the most common gut parasites found in the intestinal tract of humans and animals. Its' association with IBS is controversial, possibly as a result of irregular shedding of parasites in stool and variation in stool detection. We aimed to screen for Blastocystis in colonic stool aspirate samples in adult patients with and without IBS undergoing colonoscopy for various indications and measure the interleukin levels (IL-8, IL-3 and IL-5). In addition to standard stool culture techniques, polymerase chain reaction (PCR) techniques were employed to detect and subtype Blastocystis. All the serum samples collected were subjected for ELISA studies to measure the interleukin levels (IL-8, IL-3 and IL-5). Among 109 (IBS n = 35 and non-IBS n = 74) adults, direct stool examination and culture of colonic aspirates were initially negative for Blastocystis. However, PCR analysis detected Blastocystis in 6 (17%) IBS and 4 (5.5%) non-IBS patients. In the six positive IBS patients by PCR method, subtype 3 was shown to be the most predominant (3/6: 50%) followed by subtype 4 (2/6; 33.3%) and subtype 5 (1/6; 16.6%). IL-8 levels were significantly elevated in the IBS Blasto group and IBS group (p<0.05) compared to non-IBS and non-IBS Blasto group. The level of IL-3 in were seen to be significantly higher in than IBS Blasto group and IBS group (p<0.05) compared to non-IBS. Meanwhile, the IL-5 levels were significantly higher in IBS Blasto group (p<0.05) compared to non-IBS and non-IBS Blasto group. This study implicates that detecting Blastosystis by PCR method using colonic aspirate samples during colonoscopy, suggests that this may be a better method for sample collection due to the parasite's irregular shedding in Blastocystis-infected stools. Patients with IBS infected with parasite showed an increase in the interleukin levels demonstrate that Blastocystis does have an effect in the immune system.
    Matched MeSH terms: Irritable Bowel Syndrome/blood; Irritable Bowel Syndrome/diagnosis*; Irritable Bowel Syndrome/parasitology*
  7. Chuah KH, Hian WX, Teoh AT, Ling JKY, Mahadeva S
    Neurogastroenterol Motil, 2023 Aug;35(8):e14602.
    PMID: 37094070 DOI: 10.1111/nmo.14602
    BACKGROUND: Real-world data on the outcome of routine treatment for disorders of gut-brain interaction (DGBI) in secondary care are lacking.

    METHOD: A longitudinal study of consecutive adult patients with various DGBI attending this institution's gastroenterology clinic was conducted. Following 2 years of treatment, the proportion of patients with symptom improvement, details of clinical therapy, factors associated with and the impact of 'no symptom improvement' were determined.

    RESULTS: A total of 289 patients (median age 68 years; 64.7% females; 28.4% irritable bowel syndrome (IBS), 20.1% functional dyspepsia (FD), 8.7% functional constipation (FC), 42.9% overlap syndrome) were recruited. After 2 years, 66.1% patients reported symptom improvement. Patients with overlap syndrome were less likely to have symptomatic improvement compared to those with a single DGBI (Overlap 55.6% vs IBS 74.4% vs FD 72.4% vs FC 76.0%, p = 0.014). Reassurance was associated with symptom improvement (p 

    Matched MeSH terms: Irritable Bowel Syndrome*
  8. Jayaraman T, Wong RK, Drossman DA, Lee YY
    J R Coll Physicians Edinb, 2017 Jun;47(2):138-141.
    PMID: 28675183 DOI: 10.4997/JRCPE.2017.206
    Irritable bowel syndrome is a disorder of gut-brain interaction that leads to a significant healthcare burden worldwide. A good physician-patient relationship is fundamental in managing patients who suffer from this poorly understood chronic disease. We highlight possible reasons for breakdown in communication between physicians and irritable bowel syndrome sufferers and suggest possible ways to overcome such pitfalls.
    Matched MeSH terms: Irritable Bowel Syndrome/diagnosis*; Irritable Bowel Syndrome/therapy*
  9. Bahrudin MF, Abdul Rani R, Tamil AM, Mokhtar NM, Raja Ali RA
    Dig Dis Sci, 2020 Feb;65(2):541-549.
    PMID: 31209720 DOI: 10.1007/s10620-019-05695-3
    BACKGROUND: This study aimed to objectively investigate whether the addition of polydextrose to sterilized probiotic containing Lactobacillus helveticus will confer benefits to constipation-predominant irritable bowel syndrome patients.

    METHODS: A total of 163 patients were randomized into two groups: Group A to consume 350 mL of sterilized probiotic with 5.85 g polydextrose daily for 1 week and Group B without polydextrose. Intestinal transit time, fecal pH, fecal weight, and modified Garrigues questionnaires for pre- and post-consumption were assessed.

    RESULTS: Median intestinal transit time was significantly reduced from 58 (IQR 43-72) to 45 (IQR 24-59) hours and 48 (IQR 31-72) to 30 (IQR 24-49) hours for Groups A and B, respectively (p bowel syndrome patients. However, daily consumption of sterilized probiotic containing L. helveticus with or without polydextrose for a week alleviated constipation-related symptoms and objectively reduced both fecal pH and intestinal transit time.

    Matched MeSH terms: Irritable Bowel Syndrome/physiopathology; Irritable Bowel Syndrome/therapy*
  10. Azad AK, Doolaanea AA, Al-Mahmood SMA, Kennedy JF, Chatterjee B, Bera H
    Int J Biol Macromol, 2021 Aug 31;185:861-875.
    PMID: 34237363 DOI: 10.1016/j.ijbiomac.2021.07.019
    Peppermint oil (PO) is the most prominent oil using in pharmaceutical formulations with its significant therapeutic value. In this sense, this oil is attracting considerable attention from the scientific community due to its traditional therapeutic claim, biological and pharmacological potential in recent research. An organic solvent-free and environment-friendly electrohydrodynamic assisted (EHDA) technique was employed to prepared PO-loaded alginate microbeads. The current study deals with the development, optimization, in vitro characterization, in vivo gastrointestinal tract drug distribution and ex-vivo mucoadhesive properties, antioxidant, and anti-inflammatory effects of PO-loaded alginate microbeads. The optimization results indicated the voltage and flow rate have a significant influence on microbeads size and sphericity factor and encapsulation efficiency. All these optimized microbeads showed a better drug release profile in simulated intestinal fluid (pH 6.8) at 2 h. However, a minor release was found in acidic media (pH 1.2) at 2 h. The optimized formulation showed excellent mucoadhesive properties in ex-vivo and good swelling characterization in intestine media. The microbeads were found to be well distributed in various parts of the intestine in in vivo study. PO-loaded alginate microbeads similarly showed potential antioxidant effects with drug release. The formulation exhibited possible improvement of irritable bowel syndrome (IBS) in MO-induced rats. It significantly suppressed proinflammatory cytokines, i.e., interleukin- IL-1β, and upregulated anti-inflammatory cytokine expression, i.e., IL-10. It would be a promising approach for targeted drug release after oral administration and could be considered an anti-inflammatory therapeutic strategy for treating IBS.
    Matched MeSH terms: Irritable Bowel Syndrome/chemically induced; Irritable Bowel Syndrome/drug therapy*
  11. Azad AK, Al-Mahmood SMA, Chatterjee B, Wan Sulaiman WMA, Elsayed TM, Doolaanea AA
    Pharmaceutics, 2020 Mar 02;12(3).
    PMID: 32131539 DOI: 10.3390/pharmaceutics12030219
    Black seed oil (BSO) has been used for various therapeutic purposes around the world since ancient eras. It is one of the most prominent oils used in nutraceutical formulations and daily consumption for its significant therapeutic value is common phenomena. The main aim of this study was to develop alginate-BSO beads as a controlled release system designed to control drug release in the gastrointestinal tract (GIT). Electrospray technology facilitates formulation of small and uniform beads with higher diffusion and swelling rates resulting in process performance improvement. The effect of different formulation and process variables was evaluated on the internal and external bead morphology, size, shape, encapsulation efficiency, swelling rate, in vitro drug release, release mechanism, ex vivo mucoadhesive strength and gastrointestinal tract qualitative and quantitative distribution. All the formulated beads showed small sizes of 0.58 ± 0.01 mm (F8) and spherical shape of 0.03 ± 0.00 mm. The coefficient of weight variation (%) ranged from 1.37 (F8) to 3.93 (F5) ng. All formulations (F1-F9) were studied in vitro for release characteristics and swelling behaviour, then the release data were fitted to various equations to determine the exponent (ns), swelling kinetic constant (ks), swelling rate (%/h), correlation coefficient (r2) and release kinetic mechanism. The oil encapsulation efficiency was almost complete at 90.13% ± 0.93% in dried beads. The maximum bead swelling rate showed 982.23 (F8, r2 = 0.996) in pH 6.8 and the drug release exceeded 90% in simulated gastrointestinal fluid (pH 6.8). Moreover, the beads were well distributed throughout various parts of the intestine. This designed formulation could possibly be advantageous in terms of increased bioavailability and targeted drug delivery to the intestine region and thus may find applications in some diseases like irritable bowel syndrome.
    Matched MeSH terms: Irritable Bowel Syndrome
  12. Rahman MM, Mahadeva S, Ghoshal UC
    World J Gastroenterol, 2017 Oct 07;23(37):6788-6801.
    PMID: 29085223 DOI: 10.3748/wjg.v23.i37.6788
    Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder, common in clinic and in the community. It has a significant impact on both society and patients' quality of life. The epidemiology, clinical presentation, and management of IBS may vary in different geographical regions due to differences in diet, gastrointestinal infection, socio-cultural and psycho-social factors, religious and illness beliefs, symptom perception and reporting. Although previous reviews and consensus reports on IBS in Asia have been published, Asia is quite diverse socio-demographically. In this context, India, Bangladesh and Malaysia share some similarities, including: (1) large proportion of the population living in rural areas; (2) rapid development and associated lifestyle changes in urban areas; and (3) dietary, cultural and religious practices. The present review explores the clinical and epidemiological data on IBS from these three major nations in South and South-East Asia. In-depth review of the literature revealed important differences between IBS in the East, as revealed by studies from these three countries, and the West; these include a predominantly rural profile, differences in bowel habit and symptom profile, raising concern with regards to diagnostic criteria and subtyping of IBS, higher dietary fiber consumption, frequent lactose malabsorption, parasitosis, and possible overlap between post-infectious IBS and tropical sprue. Moreover, the current perception on difference in prevalence of the disorder in these countries, as compared to the West, might be related to variation in survey methods.
    Matched MeSH terms: Irritable Bowel Syndrome/diagnosis; Irritable Bowel Syndrome/etiology; Irritable Bowel Syndrome/epidemiology*; Irritable Bowel Syndrome/therapy
  13. Alt F, Chong PW, Teng E, Uebelhack R
    Phytother Res, 2017 Jul;31(7):1056-1062.
    PMID: 28508427 DOI: 10.1002/ptr.5826
    Irritable bowel syndrome (IBS) is a functional bowel disorder of unknown aetiology. There is currently no known cure, and pharmacological interventions are usually targeting symptomatic relief, where natural and herbal remedies also play a role. This study aimed to evaluate the benefit and tolerability of IQP-CL-101 in symptomatic IBS relief. A double-blinded, randomised, placebo-controlled trial was conducted over 8 weeks. A total of 99 subjects fulfilling ROME-III criteria for IBS were randomised into two groups, given either two IQP-CL-101 softgels or matching placebo twice daily before main meals. The primary endpoint was the difference in change of IBS Symptom Severity Score (IBS-SSS) after an 8-week intake of IQP-CL-101 compared to placebo. After 8 weeks, subjects on IQP-CL-101 showed a significant reduction in IBS-SSS (113.0 ± 64.9-point reduction) compared to subjects on placebo (38.7 ± 64.5-point reduction) (p 
    Matched MeSH terms: Irritable Bowel Syndrome/drug therapy*
  14. Yusof N, Hamid N, Ma ZF, Lawenko RM, Wan Mohammad WMZ, Collins DA, et al.
    Gut Pathog, 2017;9:75.
    PMID: 29255490 DOI: 10.1186/s13099-017-0224-7
    Background: After an environmental disaster, the affected community is at increased risk for persistent abdominal pain but mechanisms are unclear. Therefore, our study aimed to determine association between abdominal pain and poor water, sanitation and hygiene (WaSH) practices, and if small intestinal bacterial overgrowth (SIBO) and/or gut dysbiosis explain IBS, impaired quality of life (QOL), anxiety and/or depression after a major flood.

    Results: New onset abdominal pain, IBS based on the Rome III criteria, WaSH practices, QOL, anxiety and/or depression, SIBO (hydrogen breath testing) and stools for metagenomic sequencing were assessed in flood victims. Of 211 participants, 37.9% (n = 80) had abdominal pain and 17% (n = 36) with IBS subtyped diarrhea and/or mixed type (n = 27 or 12.8%) being the most common. Poor WaSH practices and impaired quality of life during flood were significantly associated with IBS. Using linear discriminant analysis effect size method, gut dysbiosis was observed in those with anxiety (Bacteroidetes and Proteobacteria, effect size 4.8), abdominal pain (Fusobacteria, Staphylococcus, Megamonas and Plesiomonas, effect size 4.0) and IBS (Plesiomonas and Trabulsiella, effect size 3.0).

    Conclusion: Disturbed gut microbiota because of environmentally-derived organisms may explain persistent abdominal pain and IBS after a major environmental disaster in the presence of poor WaSH practices.

    Matched MeSH terms: Irritable Bowel Syndrome
  15. Ragavan ND, Govind SK, Chye TT, Mahadeva S
    Parasitol Res, 2015 Aug;114(8):2999-3005.
    PMID: 25982571 DOI: 10.1007/s00436-015-4502-3
    Blastocystis is one of the most common gut parasites found in the intestinal tract of humans and animals. We have previously reported the irregular shedding of Blastocystis cysts in stools from infected patients. In the present study, we assess the factors influencing shedding patterns from a Blastocystis ST3-infected IBS patient. The stools samples were voluntarily submitted for examination for a period of 30 days from Blastocystis ST3-infected IBS patient. A questionnaire on the factors that could influence the shedding pattern of the cysts was designed to assess the following information: (a) the frequency of frequenting the toilet in a day, (b) the timing of frequenting the toilet, (c) the stool forms, (d) the type of mood the patient was in when frequenting the toilet and (e) food intake. A total of 79 stool samples were collected for 30 days. The highest number of cysts recorded when the patient visited the toilet three times a day was 22.2 × 10(6) cysts/g. Frequenting the toilet between 6 a.m. to 11.59 a.m. showed the highest number of cysts, i.e. 21.7 × 10(6) cysts/g. Semi-solid forms showed the highest cyst count, i.e. 2.00 × 10(6) cysts/g. Irregular shedding of cysts was seen in 10 out of 30 days where the widest range recorded on day 17 was between 0 to 1.2 × 10(6) cysts/g. The average daily cyst count on days of emotional fluctuations was from 0 to 5.13 × 10(6) cysts/g. In conclusion, the study confirms that there are factors influencing shedding patterns of Blastocystis, and these have important implications when it comes to diagnosis and transmission of the parasite.
    Matched MeSH terms: Irritable Bowel Syndrome/parasitology*
  16. Chua CS, Huang SY, Cheng CW, Bai CH, Hsu CY, Chiu HW, et al.
    Medicine (Baltimore), 2017 Dec;96(49):e9094.
    PMID: 29245334 DOI: 10.1097/MD.0000000000009094
    Abdominal pain is one of the key symptoms of irritable bowel syndrome (IBS). Studies have indicated an increase in the incidence of IBS in Asia. However, yet the pathophysiology of this disease remains unknown. Women are more likely to develop the condition than men, especially the constipation-predominant type. Essential fatty acid (EFA) malnutrition is one of several theories discussing the mechanism of IBS.The authors hypothesized that significant EFA deficiency may cause abdominal pain in patients with IBS. However, because patterns in the oral intake of EFAs differ between cultures, the authors narrowed this study to examine the nutritional status of Asian female patients with IBSThe authors investigated Asian female patients with IBS and compared them with a group of healthy controls. Thirty patients with IBS and 39 healthy individuals were included in this study. The participants' age, height, weight, and waist size were recorded. The 24-item Hamilton Depression Rating Scale was documented. Both erythrocyte and plasma fatty acid content were analyzed through gas-liquid chromatography.The authors found that patients with IBS exhibited significantly higher scores for depression, higher proportions of plasma saturated fatty acids and monounsaturated fatty acids, and lower proportions of docosahexaenoic acid and total omega-3 polyunsaturated fatty acids in plasma are associated with IBS in Asian female patients. Further study is indicated to confirm the causality of this association.
    Matched MeSH terms: Irritable Bowel Syndrome/blood*; Irritable Bowel Syndrome/epidemiology*
  17. Patimah AW, Lee YY, Dariah MY
    BMC Gastroenterol, 2017 Nov 02;17(1):115.
    PMID: 29096625 DOI: 10.1186/s12876-017-0672-z
    BACKGROUND: In clinical practice, assessment of constipation depends on reliability, consistency and frequency of several commonly reported or core symptoms. It is not known if frequency patterns of constipation symptoms in adults are different between the West and the East. This review aimed to describe core constipation symptoms and their frequency patterns among the Asian adults.

    METHODS: Articles published in PubMed, MEDLINE, CINAHL and Science Direct from 2005 to 2015 were searched systematically. Studies were included if constipation satisfied the Rome II and or III criteria. Study populations consisted of Asian adults above 18 years old and with sample size above 50.

    RESULTS: Of 2812 articles screened, 11 met the eligibility criteria. Constipation among Asian adults was characterized by three core symptoms of 'straining' at 82.8%, 'lumpy and hard stool' at 74.2% and 'sensation of incomplete evacuation' at 68.1% and the least frequent symptom was 'manual maneuver to facilitate defecation' at 23.3%. There was heterogeneity in frequency patterns of core symptoms between different Asian studies but also differences in core symptoms between constipation subtypes of functional constipation and irritable bowel syndrome with constipation.

    CONCLUSIONS: In general, Asian adults perceive constipation symptoms in a similar but not equivalent manner to the West. Recognition of core symptoms will increase the diagnostic confidence of constipation and its subtypes but more studies of the various specific Asian populations are needed to address their differences.

    Matched MeSH terms: Irritable Bowel Syndrome/diagnosis
  18. Quek SXZ, Loo EXL, Demutska A, Chua CE, Kew GS, Wong S, et al.
    J Gastroenterol Hepatol, 2021 Aug;36(8):2187-2197.
    PMID: 33615534 DOI: 10.1111/jgh.15466
    BACKGROUND AND AIM: Gastrointestinal manifestations of the coronavirus disease 2019 (COVID-19) pandemic may mimic irritable bowel syndrome (IBS), and social distancing measures may affect IBS patients negatively. We aimed to study the impact of COVID-19 on respondents with self-reported IBS.

    METHODS: We conducted an anonymized survey from May to June 2020 in 33 countries. Knowledge, attitudes, and practices on personal hygiene and social distancing as well as psychological impact of COVID-19 were assessed. Statistical analysis was performed to determine differences in well-being and compliance to social distancing measures between respondents with and without self-reported IBS. Factors associated with improvement or worsening of IBS symptoms were evaluated.

    RESULTS: Out of 2704 respondents, 2024 (74.9%) did not have IBS, 305 (11.3%) had self-reported IBS, and 374 (13.8%) did not know what IBS was. Self-reported IBS respondents reported significantly worse emotional, social, and psychological well-being compared with non-IBS respondents and were less compliant to social distancing measures (28.2% vs 35.3%, P = 0.029); 61.6% reported no change, 26.6% reported improvement, and 11.8% reported worsening IBS symptoms. Higher proportion of respondents with no change in IBS symptoms were willing to practice social distancing indefinitely versus those who deteriorated (74.9% vs 51.4%, P = 0.016). In multivariate analysis, willingness to continue social distancing for another 2-3 weeks (vs longer period) was significantly associated with higher odds of worsening IBS.

    CONCLUSION: Our study showed that self-reported IBS respondents had worse well-being and compliance to social distancing measures than non-IBS respondents. Future research will focus on occupational stress and dietary changes during COVID-19 that may influence IBS.

    Matched MeSH terms: Irritable Bowel Syndrome/epidemiology*
  19. Aziz MNM, Kumar J, Muhammad Nawawi KN, Raja Ali RA, Mokhtar NM
    Nutrients, 2021 Aug 31;13(9).
    PMID: 34578939 DOI: 10.3390/nu13093061
    Patients with irritable bowel syndrome (IBS) are increasingly presenting with a wide range of neuropsychiatric symptoms, such as deterioration in gastroenteric physiology, including visceral hypersensitivity, altered intestinal membrane permeability, and gastrointestinal motor dysfunction. Functional imaging of IBS patients has revealed several abnormalities in various brain regions, such as significant activation of amygdala, thinning of insular and anterior cingulate cortex, and increase in hypothalamic gray matter, which results in poor psychiatric and cognitive outcomes. Interrelations between the enteric and central events in IBS-related gastrointestinal, neurological, and psychiatric pathologies have compelled researchers to study the gut-brain axis-a bidirectional communication that maintains the homeostasis of the gastrointestinal and central nervous system with gut microbiota as the protagonist. Thus, it can be disrupted by any alteration owing to the gut dysbiosis or loss of diversity in microbial composition. Available evidence indicates that the use of probiotics as a part of a balanced diet is effective in the management of IBS and IBS-associated neurodegenerative and psychiatric comorbidities. In this review, we delineate the pathogenesis and complications of IBS from gastrointestinal and neuropsychiatric standpoints while also discussing the neurodegenerative events in enteric and central nervous systems of IBS patients and the therapeutic potential of gut microbiota-based therapy established on clinical and preclinical data.
    Matched MeSH terms: Irritable Bowel Syndrome/epidemiology*; Irritable Bowel Syndrome/physiopathology
  20. Abdul Rani R, Raja Ali RA, Lee YY
    Intest Res, 2016 Oct;14(4):297-304.
    PMID: 27799880
    Irritable bowel syndrome (IBS), a common gastrointestinal disorder involving the gut-brain axis, and inflammatory bowel disease (IBD), a chronic relapsing inflammatory disorder, are both increasing in incidence and prevalence in Asia. Both have significant overlap in terms of symptoms, pathophysiology, and treatment, suggesting the possibility of IBS and IBD being a single disease entity albeit at opposite ends of the spectrum. We examined the similarities and differences in IBS and IBD, and offer new thoughts and approaches to the disease paradigm.
    Matched MeSH terms: Irritable Bowel Syndrome
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