Key clinical point: The colonic microbial environment changes with exacerbation of symptoms in patients with irritable bowel syndrome with diarrhea (IBS-D).

Major finding: The fecal alpha-diversity was significantly different between IBS without vs with symptom exacerbation (P < .01). The transcription levels of genes involved in enzymatic glutamine to tryptophan synthesis, putrescine to GABA synthesis, inositol degradation, menaquinone synthesis, crotonyl-CoA to butyrate synthesis, and propionate synthesis were significantly lower in IBS with vs without symptom exacerbation (P < .05).

Study details: Findings are from an analysis of 43 male patients with IBS-D and 40 healthy male controls.

Disclosures: This study was supported by grants from JSPS KAKENHI, Japan, the Japanese Food Science Institute Foundation, and others. The authors declared no conflicts of interest.

Source: Tanaka Y et al. Omics profiles of fecal and oral microbiota change in irritable bowel syndrome patients with diarrhea and symptom exacerbation. J Gastroenterol. 2022 (Jul 30).  Doi: 10.1007/s00535-022-01888-2

Key clinical point: The colonic microbial environment changes with exacerbation of symptoms in patients with irritable bowel syndrome with diarrhea (IBS-D).

Major finding: The fecal alpha-diversity was significantly different between IBS without vs with symptom exacerbation (P < .01). The transcription levels of genes involved in enzymatic glutamine to tryptophan synthesis, putrescine to GABA synthesis, inositol degradation, menaquinone synthesis, crotonyl-CoA to butyrate synthesis, and propionate synthesis were significantly lower in IBS with vs without symptom exacerbation (P < .05).

Study details: Findings are from an analysis of 43 male patients with IBS-D and 40 healthy male controls.

Disclosures: This study was supported by grants from JSPS KAKENHI, Japan, the Japanese Food Science Institute Foundation, and others. The authors declared no conflicts of interest.

Source: Tanaka Y et al. Omics profiles of fecal and oral microbiota change in irritable bowel syndrome patients with diarrhea and symptom exacerbation. J Gastroenterol. 2022 (Jul 30).  Doi: 10.1007/s00535-022-01888-2

Key clinical point: The colonic microbial environment changes with exacerbation of symptoms in patients with irritable bowel syndrome with diarrhea (IBS-D).

Major finding: The fecal alpha-diversity was significantly different between IBS without vs with symptom exacerbation (P < .01). The transcription levels of genes involved in enzymatic glutamine to tryptophan synthesis, putrescine to GABA synthesis, inositol degradation, menaquinone synthesis, crotonyl-CoA to butyrate synthesis, and propionate synthesis were significantly lower in IBS with vs without symptom exacerbation (P < .05).

Study details: Findings are from an analysis of 43 male patients with IBS-D and 40 healthy male controls.

Disclosures: This study was supported by grants from JSPS KAKENHI, Japan, the Japanese Food Science Institute Foundation, and others. The authors declared no conflicts of interest.

Source: Tanaka Y et al. Omics profiles of fecal and oral microbiota change in irritable bowel syndrome patients with diarrhea and symptom exacerbation. J Gastroenterol. 2022 (Jul 30).  Doi: 10.1007/s00535-022-01888-2

Key clinical point: A starch‐ and sucrose‐reduced diet (SSRD) led to a significant shift in the gut microbiota, which correlated with reduced gastrointestinal (GI) symptoms, in patients with irritable bowel syndrome (IBS).

Major finding: A significant shift in beta-diversity was observed in the intervention group (P < .001), along with a significant increase in the abundance of Proteobacteria (P  =  .0036), Lentisphaerae (P  =  .0038), and Cyanobacteria (P  =  .038) and a decrease in Bacteroidetes (P < .001). The abundance of Proteobacteria correlated positively (P  =  .0016) and Bacteroidetes negatively (P  =  .0017) with reduced total GI symptoms.

Study details: This study included 105 patients with IBS who were randomly assigned to receive a 4‐week SSRD intervention (n = 80) or habitual (n = 25) diet.

Disclosures: This study was partially funded by the Skåne University Hospital Foundation, Dir Albert Påhlsson Foundation, and others. The authors declared no conflicts of interest.

Source: Nilholm C et al. A starch- and sucrose-reduced dietary intervention in irritable bowel syndrome patients produced a shift in gut microbiota composition along with changes in phylum, genus, and amplicon sequence variant abundances, without affecting the micro-RNA levels. United European Gastroenterol J. 2022;10(4):363-375 (Apr 28). Doi: 10.1002/ueg2.12227

Key clinical point: A starch‐ and sucrose‐reduced diet (SSRD) led to a significant shift in the gut microbiota, which correlated with reduced gastrointestinal (GI) symptoms, in patients with irritable bowel syndrome (IBS).

Major finding: A significant shift in beta-diversity was observed in the intervention group (P < .001), along with a significant increase in the abundance of Proteobacteria (P  =  .0036), Lentisphaerae (P  =  .0038), and Cyanobacteria (P  =  .038) and a decrease in Bacteroidetes (P < .001). The abundance of Proteobacteria correlated positively (P  =  .0016) and Bacteroidetes negatively (P  =  .0017) with reduced total GI symptoms.

Study details: This study included 105 patients with IBS who were randomly assigned to receive a 4‐week SSRD intervention (n = 80) or habitual (n = 25) diet.

Disclosures: This study was partially funded by the Skåne University Hospital Foundation, Dir Albert Påhlsson Foundation, and others. The authors declared no conflicts of interest.

Source: Nilholm C et al. A starch- and sucrose-reduced dietary intervention in irritable bowel syndrome patients produced a shift in gut microbiota composition along with changes in phylum, genus, and amplicon sequence variant abundances, without affecting the micro-RNA levels. United European Gastroenterol J. 2022;10(4):363-375 (Apr 28). Doi: 10.1002/ueg2.12227

Key clinical point: A starch‐ and sucrose‐reduced diet (SSRD) led to a significant shift in the gut microbiota, which correlated with reduced gastrointestinal (GI) symptoms, in patients with irritable bowel syndrome (IBS).

Major finding: A significant shift in beta-diversity was observed in the intervention group (P < .001), along with a significant increase in the abundance of Proteobacteria (P  =  .0036), Lentisphaerae (P  =  .0038), and Cyanobacteria (P  =  .038) and a decrease in Bacteroidetes (P < .001). The abundance of Proteobacteria correlated positively (P  =  .0016) and Bacteroidetes negatively (P  =  .0017) with reduced total GI symptoms.

Study details: This study included 105 patients with IBS who were randomly assigned to receive a 4‐week SSRD intervention (n = 80) or habitual (n = 25) diet.

Disclosures: This study was partially funded by the Skåne University Hospital Foundation, Dir Albert Påhlsson Foundation, and others. The authors declared no conflicts of interest.

Source: Nilholm C et al. A starch- and sucrose-reduced dietary intervention in irritable bowel syndrome patients produced a shift in gut microbiota composition along with changes in phylum, genus, and amplicon sequence variant abundances, without affecting the micro-RNA levels. United European Gastroenterol J. 2022;10(4):363-375 (Apr 28). Doi: 10.1002/ueg2.12227

Key clinical point: A diet low in fat and copper and rich in fiber and zinc might benefit patients with comorbid migraine and irritable bowel syndrome (IBS).

Major finding: The frequency of migraine attacks per month and IBS severity scores were positively correlated with dietary intake of fats and copper (all P < .05) and negatively correlated with dietary intake of fibers and zinc (all P < .05).

Study details: Findings are from a cross-sectional study including 100 patients with concomitant migraine and IBS.

Disclosures: This study did not receive any funding, except open access funding provided by The Science, Technology, & Innovation Funding Authority in cooperation with The Egyptian Knowledge Bank. The authors declared no conflicts of interest.

Source: Magdy R et al. The potential impact of nutritional intake on symptoms severity in patients with comorbid migraine and irritable bowel syndrome. BMC Neurol. 2022;22:199 (May 30). Doi: 10.1186/s12883-022-02723-0

Key clinical point: A diet low in fat and copper and rich in fiber and zinc might benefit patients with comorbid migraine and irritable bowel syndrome (IBS).

Major finding: The frequency of migraine attacks per month and IBS severity scores were positively correlated with dietary intake of fats and copper (all P < .05) and negatively correlated with dietary intake of fibers and zinc (all P < .05).

Study details: Findings are from a cross-sectional study including 100 patients with concomitant migraine and IBS.

Disclosures: This study did not receive any funding, except open access funding provided by The Science, Technology, & Innovation Funding Authority in cooperation with The Egyptian Knowledge Bank. The authors declared no conflicts of interest.

Source: Magdy R et al. The potential impact of nutritional intake on symptoms severity in patients with comorbid migraine and irritable bowel syndrome. BMC Neurol. 2022;22:199 (May 30). Doi: 10.1186/s12883-022-02723-0

Key clinical point: A diet low in fat and copper and rich in fiber and zinc might benefit patients with comorbid migraine and irritable bowel syndrome (IBS).

Major finding: The frequency of migraine attacks per month and IBS severity scores were positively correlated with dietary intake of fats and copper (all P < .05) and negatively correlated with dietary intake of fibers and zinc (all P < .05).

Study details: Findings are from a cross-sectional study including 100 patients with concomitant migraine and IBS.

Disclosures: This study did not receive any funding, except open access funding provided by The Science, Technology, & Innovation Funding Authority in cooperation with The Egyptian Knowledge Bank. The authors declared no conflicts of interest.

Source: Magdy R et al. The potential impact of nutritional intake on symptoms severity in patients with comorbid migraine and irritable bowel syndrome. BMC Neurol. 2022;22:199 (May 30). Doi: 10.1186/s12883-022-02723-0

Key clinical point: In patients newly diagnosed with irritable bowel syndrome (IBS), an 8-week fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP)-lowering diet application was superior to a spasmolytic agent, otilonium bromide (OB), in improving disease symptoms.

Major finding: At 8 weeks, the response rate (71% vs 61%; P  =  .03) and treatment adherence rate (94% vs 73%; P < .001) were significantly higher in the diet vs OB arm, with the improvement in IBS Symptom Severity Score being significantly higher in the diet group (P  =  .02). No serious adverse reactions were recorded.

Study details: Findings are from the DOMINO trial that included 459 primary care patients with IBS who were randomly assigned to the 8-week OB (40 mg, 3 times/day) or FODMAP-lowering diet application group.

Disclosures: This study was funded through the Belgian Health Care Knowledge Centre and others. The authors declared serving as scientific advisors or on speaker bureaus or receiving research support or grants from various sources.

Source: Carbone F et al. Diet or medication in primary care patients with IBS: The DOMINO study - a randomized trial supported by the Belgian Health Care Knowledge Centre (KCE Trials Programme) and the Rome Foundation Research Institute. Gut. 2022 (Apr 28). Doi: 10.1136/gutjnl-2021-325821

Key clinical point: In patients newly diagnosed with irritable bowel syndrome (IBS), an 8-week fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP)-lowering diet application was superior to a spasmolytic agent, otilonium bromide (OB), in improving disease symptoms.

Major finding: At 8 weeks, the response rate (71% vs 61%; P  =  .03) and treatment adherence rate (94% vs 73%; P < .001) were significantly higher in the diet vs OB arm, with the improvement in IBS Symptom Severity Score being significantly higher in the diet group (P  =  .02). No serious adverse reactions were recorded.

Study details: Findings are from the DOMINO trial that included 459 primary care patients with IBS who were randomly assigned to the 8-week OB (40 mg, 3 times/day) or FODMAP-lowering diet application group.

Disclosures: This study was funded through the Belgian Health Care Knowledge Centre and others. The authors declared serving as scientific advisors or on speaker bureaus or receiving research support or grants from various sources.

Source: Carbone F et al. Diet or medication in primary care patients with IBS: The DOMINO study - a randomized trial supported by the Belgian Health Care Knowledge Centre (KCE Trials Programme) and the Rome Foundation Research Institute. Gut. 2022 (Apr 28). Doi: 10.1136/gutjnl-2021-325821

Key clinical point: In patients newly diagnosed with irritable bowel syndrome (IBS), an 8-week fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP)-lowering diet application was superior to a spasmolytic agent, otilonium bromide (OB), in improving disease symptoms.

Major finding: At 8 weeks, the response rate (71% vs 61%; P  =  .03) and treatment adherence rate (94% vs 73%; P < .001) were significantly higher in the diet vs OB arm, with the improvement in IBS Symptom Severity Score being significantly higher in the diet group (P  =  .02). No serious adverse reactions were recorded.

Study details: Findings are from the DOMINO trial that included 459 primary care patients with IBS who were randomly assigned to the 8-week OB (40 mg, 3 times/day) or FODMAP-lowering diet application group.

Disclosures: This study was funded through the Belgian Health Care Knowledge Centre and others. The authors declared serving as scientific advisors or on speaker bureaus or receiving research support or grants from various sources.

Source: Carbone F et al. Diet or medication in primary care patients with IBS: The DOMINO study - a randomized trial supported by the Belgian Health Care Knowledge Centre (KCE Trials Programme) and the Rome Foundation Research Institute. Gut. 2022 (Apr 28). Doi: 10.1136/gutjnl-2021-325821

Key clinical point: This meta-analysis demonstrated the superiority of peppermint oil over placebo for improvements in the signs and symptoms of irritable bowel syndrome (IBS); however, adverse events were more frequent with peppermint oil use.

Major finding: Peppermint oil was superior to placebo for global IBS symptoms (relative risk [RR] for persisting global IBS symptoms 0.65; 95% CI 0.43-0.98) and abdominal pain (RR for no improvement in abdominal pain 0.76; 95% CI 0.62-0.93) after therapy. The rate of any adverse events (RR 1.57; 95% CI 1.04-2.37), particularly gastroesophageal reflux symptoms, was higher among patients receiving peppermint oil.

Study details: The data come from a meta-analysis of 10 randomized controlled trials including 1030 patients with IBS, of which 525 were assigned to receive peppermint oil.

Disclosures: This study received no external funding. No conflicts of interest were declared.

Source: Ingrosso MR et al. Systematic review and meta-analysis: Efficacy of peppermint oil in irritable bowel syndrome. Aliment Pharmacol Ther. 2022 (Aug 9). Doi: 10.1111/apt.17179

Key clinical point: This meta-analysis demonstrated the superiority of peppermint oil over placebo for improvements in the signs and symptoms of irritable bowel syndrome (IBS); however, adverse events were more frequent with peppermint oil use.

Major finding: Peppermint oil was superior to placebo for global IBS symptoms (relative risk [RR] for persisting global IBS symptoms 0.65; 95% CI 0.43-0.98) and abdominal pain (RR for no improvement in abdominal pain 0.76; 95% CI 0.62-0.93) after therapy. The rate of any adverse events (RR 1.57; 95% CI 1.04-2.37), particularly gastroesophageal reflux symptoms, was higher among patients receiving peppermint oil.

Study details: The data come from a meta-analysis of 10 randomized controlled trials including 1030 patients with IBS, of which 525 were assigned to receive peppermint oil.

Disclosures: This study received no external funding. No conflicts of interest were declared.

Source: Ingrosso MR et al. Systematic review and meta-analysis: Efficacy of peppermint oil in irritable bowel syndrome. Aliment Pharmacol Ther. 2022 (Aug 9). Doi: 10.1111/apt.17179

Key clinical point: This meta-analysis demonstrated the superiority of peppermint oil over placebo for improvements in the signs and symptoms of irritable bowel syndrome (IBS); however, adverse events were more frequent with peppermint oil use.

Major finding: Peppermint oil was superior to placebo for global IBS symptoms (relative risk [RR] for persisting global IBS symptoms 0.65; 95% CI 0.43-0.98) and abdominal pain (RR for no improvement in abdominal pain 0.76; 95% CI 0.62-0.93) after therapy. The rate of any adverse events (RR 1.57; 95% CI 1.04-2.37), particularly gastroesophageal reflux symptoms, was higher among patients receiving peppermint oil.

Study details: The data come from a meta-analysis of 10 randomized controlled trials including 1030 patients with IBS, of which 525 were assigned to receive peppermint oil.

Disclosures: This study received no external funding. No conflicts of interest were declared.

Source: Ingrosso MR et al. Systematic review and meta-analysis: Efficacy of peppermint oil in irritable bowel syndrome. Aliment Pharmacol Ther. 2022 (Aug 9). Doi: 10.1111/apt.17179

Key clinical point: This meta-analysis found insufficient evidence on the beneficial effects of vitamin D supplementation on irritable bowel syndrome (IBS) symptoms; however, supplementation with vitamin D significantly improved the quality of life (QoL) in patients with IBS.

Major finding: Patients receiving vitamin D supplementation showed a significant improvement in IBS-QoL scores compared with those receiving placebo (mean difference 6.19; P  =  .04). However, IBS-Severity Scoring System scores were not significantly different between the treatment arms.

Study details: The data come from a systematic review and meta-analysis articles of 6 randomized control studies including 616 participants.

Disclosures: This study received no external funding. No conflicts of interest were declared.

Source: Abuelazm M et al. The effect of vitamin D supplementation on the severity of symptoms and the quality of life in irritable bowel syndrome patients: A systematic review and meta-analysis of randomized controlled trials. Nutrients. 2022;14(13):2618 (Jun 24). Doi: 10.3390/nu14132618

Key clinical point: This meta-analysis found insufficient evidence on the beneficial effects of vitamin D supplementation on irritable bowel syndrome (IBS) symptoms; however, supplementation with vitamin D significantly improved the quality of life (QoL) in patients with IBS.

Major finding: Patients receiving vitamin D supplementation showed a significant improvement in IBS-QoL scores compared with those receiving placebo (mean difference 6.19; P  =  .04). However, IBS-Severity Scoring System scores were not significantly different between the treatment arms.

Study details: The data come from a systematic review and meta-analysis articles of 6 randomized control studies including 616 participants.

Disclosures: This study received no external funding. No conflicts of interest were declared.

Source: Abuelazm M et al. The effect of vitamin D supplementation on the severity of symptoms and the quality of life in irritable bowel syndrome patients: A systematic review and meta-analysis of randomized controlled trials. Nutrients. 2022;14(13):2618 (Jun 24). Doi: 10.3390/nu14132618

Key clinical point: This meta-analysis found insufficient evidence on the beneficial effects of vitamin D supplementation on irritable bowel syndrome (IBS) symptoms; however, supplementation with vitamin D significantly improved the quality of life (QoL) in patients with IBS.

Major finding: Patients receiving vitamin D supplementation showed a significant improvement in IBS-QoL scores compared with those receiving placebo (mean difference 6.19; P  =  .04). However, IBS-Severity Scoring System scores were not significantly different between the treatment arms.

Study details: The data come from a systematic review and meta-analysis articles of 6 randomized control studies including 616 participants.

Disclosures: This study received no external funding. No conflicts of interest were declared.

Source: Abuelazm M et al. The effect of vitamin D supplementation on the severity of symptoms and the quality of life in irritable bowel syndrome patients: A systematic review and meta-analysis of randomized controlled trials. Nutrients. 2022;14(13):2618 (Jun 24). Doi: 10.3390/nu14132618

Key clinical point: Internet-delivered cognitive behavioral therapy (ICBT) significantly improved irritable bowel syndrome (IBS) symptom severity and quality of life (QoL) and was cost-effective in patients with IBS.

Major finding: Compared with the standard care, ICBT led to a significant reduction in IBS symptom severity (standardized mean difference [SMD] −0.575; 95% CI −0.714 to −0.435) and total cost including intervention cost (SMD −0.372; 95% CI −0.704 to −0.039) and improved QoL (SMD 0.582; 95% CI 0.396 to 0.769), with effects on IBS symptom severity being prominent even at 12-24 months postintervention (SMD −0.357; 95% CI −0.541 to −0.172).

Study details: Findings are from a meta-analysis of 9 randomized controlled studies that evaluated the application of ICBT in patients with IBS.

Disclosures: This study was supported by the National Research Foundation of Korea. The authors declared no conflicts of interest.

Source: Kim H et al. Internet-delivered cognitive behavioral therapy in patients with irritable bowel syndrome: Systematic review and meta-analysis. J Med Internet Res. 2022;24(6):e35260 (Jun 10). Doi: 10.2196/35260

Key clinical point: Internet-delivered cognitive behavioral therapy (ICBT) significantly improved irritable bowel syndrome (IBS) symptom severity and quality of life (QoL) and was cost-effective in patients with IBS.

Major finding: Compared with the standard care, ICBT led to a significant reduction in IBS symptom severity (standardized mean difference [SMD] −0.575; 95% CI −0.714 to −0.435) and total cost including intervention cost (SMD −0.372; 95% CI −0.704 to −0.039) and improved QoL (SMD 0.582; 95% CI 0.396 to 0.769), with effects on IBS symptom severity being prominent even at 12-24 months postintervention (SMD −0.357; 95% CI −0.541 to −0.172).

Study details: Findings are from a meta-analysis of 9 randomized controlled studies that evaluated the application of ICBT in patients with IBS.

Disclosures: This study was supported by the National Research Foundation of Korea. The authors declared no conflicts of interest.

Source: Kim H et al. Internet-delivered cognitive behavioral therapy in patients with irritable bowel syndrome: Systematic review and meta-analysis. J Med Internet Res. 2022;24(6):e35260 (Jun 10). Doi: 10.2196/35260

Key clinical point: Internet-delivered cognitive behavioral therapy (ICBT) significantly improved irritable bowel syndrome (IBS) symptom severity and quality of life (QoL) and was cost-effective in patients with IBS.

Major finding: Compared with the standard care, ICBT led to a significant reduction in IBS symptom severity (standardized mean difference [SMD] −0.575; 95% CI −0.714 to −0.435) and total cost including intervention cost (SMD −0.372; 95% CI −0.704 to −0.039) and improved QoL (SMD 0.582; 95% CI 0.396 to 0.769), with effects on IBS symptom severity being prominent even at 12-24 months postintervention (SMD −0.357; 95% CI −0.541 to −0.172).

Study details: Findings are from a meta-analysis of 9 randomized controlled studies that evaluated the application of ICBT in patients with IBS.

Disclosures: This study was supported by the National Research Foundation of Korea. The authors declared no conflicts of interest.

Source: Kim H et al. Internet-delivered cognitive behavioral therapy in patients with irritable bowel syndrome: Systematic review and meta-analysis. J Med Internet Res. 2022;24(6):e35260 (Jun 10). Doi: 10.2196/35260

Key clinical point: Fecal and intestinal mucosal microbiota are distinctly different in patients with constipation-predominant or diarrhea-predominant irritable bowel syndrome (IBS-C or IBS-D), with microbiota changes being correlated with clinical manifestations of IBS.

Major finding: Community richness and diversity of the fecal microbiota were significantly lower in patients with IBS-C or IBS-D vs healthy controls (HC; P < .05). The fecal microbiota showed a shift in the abundance of Bacteroides caccae and Roseburia (both P < .05) in patients with IBS vs HC, with both correlating with abdominal pain and distension (P < .05). In terminal ileum, Bifidobacterium and Eubacterium correlated with abdominal pain (P < .05).

Study details: This study evaluated fecal and intestinal mucosal samples from 14 patients with IBS-C, 20 patients with IBS-D, and 20 HC.

Disclosures: This study was funded by the Projects of Science and Technology for Social Development and the Innovation Engineering Project of Science and Technology in Shaanxi Province, China. The authors declared no conflicts of interest.

Source: Hou Y et al. Distinctions between fecal and intestinal mucosal microbiota in subgroups of irritable bowel syndrome. Dig Dis Sci. 2022 (Jul 25). Doi: 10.1007/s10620-022-07588-4

Key clinical point: Fecal and intestinal mucosal microbiota are distinctly different in patients with constipation-predominant or diarrhea-predominant irritable bowel syndrome (IBS-C or IBS-D), with microbiota changes being correlated with clinical manifestations of IBS.

Major finding: Community richness and diversity of the fecal microbiota were significantly lower in patients with IBS-C or IBS-D vs healthy controls (HC; P < .05). The fecal microbiota showed a shift in the abundance of Bacteroides caccae and Roseburia (both P < .05) in patients with IBS vs HC, with both correlating with abdominal pain and distension (P < .05). In terminal ileum, Bifidobacterium and Eubacterium correlated with abdominal pain (P < .05).

Study details: This study evaluated fecal and intestinal mucosal samples from 14 patients with IBS-C, 20 patients with IBS-D, and 20 HC.

Disclosures: This study was funded by the Projects of Science and Technology for Social Development and the Innovation Engineering Project of Science and Technology in Shaanxi Province, China. The authors declared no conflicts of interest.

Source: Hou Y et al. Distinctions between fecal and intestinal mucosal microbiota in subgroups of irritable bowel syndrome. Dig Dis Sci. 2022 (Jul 25). Doi: 10.1007/s10620-022-07588-4

Key clinical point: Fecal and intestinal mucosal microbiota are distinctly different in patients with constipation-predominant or diarrhea-predominant irritable bowel syndrome (IBS-C or IBS-D), with microbiota changes being correlated with clinical manifestations of IBS.

Major finding: Community richness and diversity of the fecal microbiota were significantly lower in patients with IBS-C or IBS-D vs healthy controls (HC; P < .05). The fecal microbiota showed a shift in the abundance of Bacteroides caccae and Roseburia (both P < .05) in patients with IBS vs HC, with both correlating with abdominal pain and distension (P < .05). In terminal ileum, Bifidobacterium and Eubacterium correlated with abdominal pain (P < .05).

Study details: This study evaluated fecal and intestinal mucosal samples from 14 patients with IBS-C, 20 patients with IBS-D, and 20 HC.

Disclosures: This study was funded by the Projects of Science and Technology for Social Development and the Innovation Engineering Project of Science and Technology in Shaanxi Province, China. The authors declared no conflicts of interest.

Source: Hou Y et al. Distinctions between fecal and intestinal mucosal microbiota in subgroups of irritable bowel syndrome. Dig Dis Sci. 2022 (Jul 25). Doi: 10.1007/s10620-022-07588-4

Key clinical point: Multiple bodily symptoms, female sex, and prior use of proton pump inhibitors (PPI) are the risk factors for irritable bowel syndrome (IBS) onset, with prior psychiatric disorder being the strongest risk factor.

Major finding: The presence of ≥2 prior psychiatric disorders was the strongest predictor of subsequent IBS (odds ratio [OR] 2.74; P  =  .006), with other risk factors in patients with prior psychiatric disorders being female sex (OR 1.87) and prior use of PPI (OR 1.73; both P < .001). Among patients without prior psychiatric disorder history, female sex (OR 4.24), fibromyalgia (OR 1.88), and prior PPI use (OR 1.73; all P < .001) most strongly predicted IBS onset.

Study details: Findings are from a prospective, population-based cohort study including 132,922 participants without prior IBS or IBS medication use at baseline who were followed-up twice during subsequent 3 years.

Disclosures: This study did not receive any funding. No conflicts of interest were declared.

Source: Creed F. Risk factors for self-reported irritable bowel syndrome with prior psychiatric disorder: The Lifelines cohort study. J Neurogastroenterol Motil. 2022;28(3):442-453 (Jul 30). Doi: 10.5056/jnm21041

Key clinical point: Multiple bodily symptoms, female sex, and prior use of proton pump inhibitors (PPI) are the risk factors for irritable bowel syndrome (IBS) onset, with prior psychiatric disorder being the strongest risk factor.

Major finding: The presence of ≥2 prior psychiatric disorders was the strongest predictor of subsequent IBS (odds ratio [OR] 2.74; P  =  .006), with other risk factors in patients with prior psychiatric disorders being female sex (OR 1.87) and prior use of PPI (OR 1.73; both P < .001). Among patients without prior psychiatric disorder history, female sex (OR 4.24), fibromyalgia (OR 1.88), and prior PPI use (OR 1.73; all P < .001) most strongly predicted IBS onset.

Study details: Findings are from a prospective, population-based cohort study including 132,922 participants without prior IBS or IBS medication use at baseline who were followed-up twice during subsequent 3 years.

Disclosures: This study did not receive any funding. No conflicts of interest were declared.

Source: Creed F. Risk factors for self-reported irritable bowel syndrome with prior psychiatric disorder: The Lifelines cohort study. J Neurogastroenterol Motil. 2022;28(3):442-453 (Jul 30). Doi: 10.5056/jnm21041

Key clinical point: Multiple bodily symptoms, female sex, and prior use of proton pump inhibitors (PPI) are the risk factors for irritable bowel syndrome (IBS) onset, with prior psychiatric disorder being the strongest risk factor.

Major finding: The presence of ≥2 prior psychiatric disorders was the strongest predictor of subsequent IBS (odds ratio [OR] 2.74; P  =  .006), with other risk factors in patients with prior psychiatric disorders being female sex (OR 1.87) and prior use of PPI (OR 1.73; both P < .001). Among patients without prior psychiatric disorder history, female sex (OR 4.24), fibromyalgia (OR 1.88), and prior PPI use (OR 1.73; all P < .001) most strongly predicted IBS onset.

Study details: Findings are from a prospective, population-based cohort study including 132,922 participants without prior IBS or IBS medication use at baseline who were followed-up twice during subsequent 3 years.

Disclosures: This study did not receive any funding. No conflicts of interest were declared.

Source: Creed F. Risk factors for self-reported irritable bowel syndrome with prior psychiatric disorder: The Lifelines cohort study. J Neurogastroenterol Motil. 2022;28(3):442-453 (Jul 30). Doi: 10.5056/jnm21041

Hypertension is a global problem that affects poorer countries as much as it affects more affluent ones, a new study suggests.

A cross-sectional study of some 1.2 million adults in low- and middle-income countries (LMICs) found that overall, rates of hypertension were similar across all levels of education and wealth.

The one outlier was Southeast Asia. There, higher levels of education and household wealth were associated with a greater prevalence of hypertension, but the absolute difference was small.

However, the authors of the study caution that hypertension may increasingly affect adults in the lowest socioeconomic groups as LMICs develop economically.

The study is published online  in the Journal of the American College of Cardiology.
 

Assumptions about hypertension are wrong

“We found that the differences in hypertension prevalence between education and household wealth groups were small in most low- and middle-income countries, so the frequent assumption that hypertension mostly affects the wealthiest and most educated groups in low-and middle-income countries appears to be largely untenable,” senior author Pascal Geldsetzer, MD, MPH, PhD, assistant professor of medicine at Stanford (Calif.) University, told this news organization.

High blood pressure is sometimes assumed to be a result of “Westernized” lifestyles characterized by a high intake of calorie-dense foods and salt and low physical activity. As a result, the condition is frequently thought of as mainly afflicting wealthier segments of society in LMICs, which may in part be responsible for the low degree of funding and attention that hypertension in LMICs has received thus far, Dr. Geldsetzer said.

Traditionally, other global health issues, particularly HIV, tuberculosis, and malaria, have received the lion’s share of government funding. Hypertension, thought to be a condition affecting more affluent countries because it is associated with obesity and a sedentary lifestyle, was ignored, he said.

Knowing the socioeconomic gradients associated with hypertension in LMICs and how these may change in the future is important for policy makers, Dr. Geldsetzer added.

Led by Tabea K. Kirschbaum, MD, Heidelberg Institute of Global Health, University of Heidelberg, Germany, the researchers examined hypertension prevalence by education and household wealth from 76 LMICs in 1,211,386 participants and assessed whether the effect was modified by the country’s gross domestic product (GDP).

Their analysis included 76 surveys, of which 58 were World Health Organization Stepwise Approach to Surveillance surveys. The median age of the participants was 40 years, and 58.5% were women.

Overall, hypertension prevalence tended to be similar across all educational and household wealth levels and across countries with lower and higher GDPs, although there were some “negligible” country and regional variations.

Treatment rates with blood pressure–lowering drugs for participants who had hypertension were higher in countries with higher GDPs.

Women were more likely to be taking medication than were men.

In some countries, the proportion of individuals taking blood pressure–lowering medication was higher in wealthier households.

In Southeast Asia, however, there was a strong association found between the prevalence of hypertension and higher household wealth levels. Compared with the least wealthy, the risk ratio for the wealthiest was 1.28 (95% confidence interval, 1.22-1.34). A similar association was found for education levels as well.

Education was negatively associated with hypertension in the Eastern Mediterranean. Rates were higher among men than among women.

In an accompanying editorial, Yashashwi Pokharel, MBBS, MSCR, from Wake Forest School of Medicine, Winston-Salem, N.C., and colleagues write:

“Now that we know that hypertension prevalence is not different in the poorest, the least educated, or the least economically developed countries, compared with their wealthier and educated counterparts, we should develop, test, and implement effective strategies to enhance global equity in hypertension care.”

Dr. Pokharel told this news organization that, despite the study’s limitations including heterogeneous data, measurement techniques, and blood pressure monitor use across countries, the signal is loud and clear.

“We urgently need to focus on turning off the faucet by addressing the major determinants of increasing hypertension burden, including the sociocultural and political determinants,” he said. “In this regard, setting funding priorities by donors for hypertension, capacity building, and testing and scaling effective population level hypertension prevention and treatment strategies, developed together with local stakeholders, can have a long-lasting effect. If we perpetuate the neglect, we will ineffectively spend more time mopping up the floor.”

Dr. Geldsetzer is a Chan Zuckerberg Biohub investigator. Dr. Pokharel reports no relevant financial relationships.

A version of this article first appeared on Medscape.com.

Hypertension is a global problem that affects poorer countries as much as it affects more affluent ones, a new study suggests.

A cross-sectional study of some 1.2 million adults in low- and middle-income countries (LMICs) found that overall, rates of hypertension were similar across all levels of education and wealth.

The one outlier was Southeast Asia. There, higher levels of education and household wealth were associated with a greater prevalence of hypertension, but the absolute difference was small.

However, the authors of the study caution that hypertension may increasingly affect adults in the lowest socioeconomic groups as LMICs develop economically.

The study is published online  in the Journal of the American College of Cardiology.
 

Assumptions about hypertension are wrong

“We found that the differences in hypertension prevalence between education and household wealth groups were small in most low- and middle-income countries, so the frequent assumption that hypertension mostly affects the wealthiest and most educated groups in low-and middle-income countries appears to be largely untenable,” senior author Pascal Geldsetzer, MD, MPH, PhD, assistant professor of medicine at Stanford (Calif.) University, told this news organization.

High blood pressure is sometimes assumed to be a result of “Westernized” lifestyles characterized by a high intake of calorie-dense foods and salt and low physical activity. As a result, the condition is frequently thought of as mainly afflicting wealthier segments of society in LMICs, which may in part be responsible for the low degree of funding and attention that hypertension in LMICs has received thus far, Dr. Geldsetzer said.

Traditionally, other global health issues, particularly HIV, tuberculosis, and malaria, have received the lion’s share of government funding. Hypertension, thought to be a condition affecting more affluent countries because it is associated with obesity and a sedentary lifestyle, was ignored, he said.

Knowing the socioeconomic gradients associated with hypertension in LMICs and how these may change in the future is important for policy makers, Dr. Geldsetzer added.

Led by Tabea K. Kirschbaum, MD, Heidelberg Institute of Global Health, University of Heidelberg, Germany, the researchers examined hypertension prevalence by education and household wealth from 76 LMICs in 1,211,386 participants and assessed whether the effect was modified by the country’s gross domestic product (GDP).

Their analysis included 76 surveys, of which 58 were World Health Organization Stepwise Approach to Surveillance surveys. The median age of the participants was 40 years, and 58.5% were women.

Overall, hypertension prevalence tended to be similar across all educational and household wealth levels and across countries with lower and higher GDPs, although there were some “negligible” country and regional variations.

Treatment rates with blood pressure–lowering drugs for participants who had hypertension were higher in countries with higher GDPs.

Women were more likely to be taking medication than were men.

In some countries, the proportion of individuals taking blood pressure–lowering medication was higher in wealthier households.

In Southeast Asia, however, there was a strong association found between the prevalence of hypertension and higher household wealth levels. Compared with the least wealthy, the risk ratio for the wealthiest was 1.28 (95% confidence interval, 1.22-1.34). A similar association was found for education levels as well.

Education was negatively associated with hypertension in the Eastern Mediterranean. Rates were higher among men than among women.

In an accompanying editorial, Yashashwi Pokharel, MBBS, MSCR, from Wake Forest School of Medicine, Winston-Salem, N.C., and colleagues write:

“Now that we know that hypertension prevalence is not different in the poorest, the least educated, or the least economically developed countries, compared with their wealthier and educated counterparts, we should develop, test, and implement effective strategies to enhance global equity in hypertension care.”

Dr. Pokharel told this news organization that, despite the study’s limitations including heterogeneous data, measurement techniques, and blood pressure monitor use across countries, the signal is loud and clear.

“We urgently need to focus on turning off the faucet by addressing the major determinants of increasing hypertension burden, including the sociocultural and political determinants,” he said. “In this regard, setting funding priorities by donors for hypertension, capacity building, and testing and scaling effective population level hypertension prevention and treatment strategies, developed together with local stakeholders, can have a long-lasting effect. If we perpetuate the neglect, we will ineffectively spend more time mopping up the floor.”

Dr. Geldsetzer is a Chan Zuckerberg Biohub investigator. Dr. Pokharel reports no relevant financial relationships.

A version of this article first appeared on Medscape.com.

Hypertension is a global problem that affects poorer countries as much as it affects more affluent ones, a new study suggests.

A cross-sectional study of some 1.2 million adults in low- and middle-income countries (LMICs) found that overall, rates of hypertension were similar across all levels of education and wealth.

The one outlier was Southeast Asia. There, higher levels of education and household wealth were associated with a greater prevalence of hypertension, but the absolute difference was small.

However, the authors of the study caution that hypertension may increasingly affect adults in the lowest socioeconomic groups as LMICs develop economically.

The study is published online  in the Journal of the American College of Cardiology.
 

Assumptions about hypertension are wrong

“We found that the differences in hypertension prevalence between education and household wealth groups were small in most low- and middle-income countries, so the frequent assumption that hypertension mostly affects the wealthiest and most educated groups in low-and middle-income countries appears to be largely untenable,” senior author Pascal Geldsetzer, MD, MPH, PhD, assistant professor of medicine at Stanford (Calif.) University, told this news organization.

High blood pressure is sometimes assumed to be a result of “Westernized” lifestyles characterized by a high intake of calorie-dense foods and salt and low physical activity. As a result, the condition is frequently thought of as mainly afflicting wealthier segments of society in LMICs, which may in part be responsible for the low degree of funding and attention that hypertension in LMICs has received thus far, Dr. Geldsetzer said.

Traditionally, other global health issues, particularly HIV, tuberculosis, and malaria, have received the lion’s share of government funding. Hypertension, thought to be a condition affecting more affluent countries because it is associated with obesity and a sedentary lifestyle, was ignored, he said.

Knowing the socioeconomic gradients associated with hypertension in LMICs and how these may change in the future is important for policy makers, Dr. Geldsetzer added.

Led by Tabea K. Kirschbaum, MD, Heidelberg Institute of Global Health, University of Heidelberg, Germany, the researchers examined hypertension prevalence by education and household wealth from 76 LMICs in 1,211,386 participants and assessed whether the effect was modified by the country’s gross domestic product (GDP).

Their analysis included 76 surveys, of which 58 were World Health Organization Stepwise Approach to Surveillance surveys. The median age of the participants was 40 years, and 58.5% were women.

Overall, hypertension prevalence tended to be similar across all educational and household wealth levels and across countries with lower and higher GDPs, although there were some “negligible” country and regional variations.

Treatment rates with blood pressure–lowering drugs for participants who had hypertension were higher in countries with higher GDPs.

Women were more likely to be taking medication than were men.

In some countries, the proportion of individuals taking blood pressure–lowering medication was higher in wealthier households.

In Southeast Asia, however, there was a strong association found between the prevalence of hypertension and higher household wealth levels. Compared with the least wealthy, the risk ratio for the wealthiest was 1.28 (95% confidence interval, 1.22-1.34). A similar association was found for education levels as well.

Education was negatively associated with hypertension in the Eastern Mediterranean. Rates were higher among men than among women.

In an accompanying editorial, Yashashwi Pokharel, MBBS, MSCR, from Wake Forest School of Medicine, Winston-Salem, N.C., and colleagues write:

“Now that we know that hypertension prevalence is not different in the poorest, the least educated, or the least economically developed countries, compared with their wealthier and educated counterparts, we should develop, test, and implement effective strategies to enhance global equity in hypertension care.”

Dr. Pokharel told this news organization that, despite the study’s limitations including heterogeneous data, measurement techniques, and blood pressure monitor use across countries, the signal is loud and clear.

“We urgently need to focus on turning off the faucet by addressing the major determinants of increasing hypertension burden, including the sociocultural and political determinants,” he said. “In this regard, setting funding priorities by donors for hypertension, capacity building, and testing and scaling effective population level hypertension prevention and treatment strategies, developed together with local stakeholders, can have a long-lasting effect. If we perpetuate the neglect, we will ineffectively spend more time mopping up the floor.”

Dr. Geldsetzer is a Chan Zuckerberg Biohub investigator. Dr. Pokharel reports no relevant financial relationships.

A version of this article first appeared on Medscape.com.