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Studies assess effectiveness of serotonin and nerve stimulants on irritable bowel syndromes
May 22, 2007Studies have shown that gastrointestinal (GI) tract function is often influenced by specific stimulants or reactors, which sometimes cause irritable bowel syndrome (IBS) or constipation. Two studies presented today at Digestive Disease Week® 2007 (DDW®) take a closer look at GI stimulation, including one examining the role of serotonin and reactions to certain types of foods and another looking at the potential therapeutic value of nerve stimulation for constipation. DDW is the largest international gathering of physicians and researchers in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery.
"We know that conditions of the bowel, such as constipation, diarrhea and irritable bowel syndrome, are quite troubling for a large number of individuals. These conditions can be highly volatile and unpredictable, but we are still trying to determine how we can manage these variables and what preventive or treatment options may help patients who suffer from these conditions," said Alan Buchman, M.D., MSPH, AGAF, Feinberg School of Medicine of Northwestern University School of Medicine. "These two studies point to options that may help doctors manage symptoms in their patients and hopefully lead to better treatment options in the future."
Olfactory Receptors on Human Intestinal Enterochromaffin (EC) Cells Function as Sensors for Spices and Odorants (Abstract #W1581)
One primary research focus in GI disorders is how and why the system reacts to certain foods or other stimulants; specifically, researchers are investigating the primary factors responsible for regulating digestion. Enterochromaffin (EC) cells, which are present throughout the digestive system, release serotonin (a chemical associated with the etiology of various diseases such as migraine, diarrhea, respiratory disturbances and hypertension) and are important in regulating gut motility. Researchers from the Technical University of Munich and the Ludwig Maximillian University of Munich in Germany investigated whether EC cells in the intestine express nasal olfactory receptors (ORs, receptors used for smelling) to determine whether odorants present in spices, fragrances, cigarettes, detergents and cosmetics may cause serotonin release, thereby provoking a GI response.
To evaluate this connection, researchers studied human EC cells isolated from mucosal biopsies by laser microdissection and an EC derived cell line. The experiments revealed expression of several ORs in the isolated EC cells, as well as the cell line. Using digital fluorescence imaging, the team found that activation of the cells with odorants caused elevation of intracellular Ca2+, followed by serotonin release up to 10-fold that of the controls. Odorants like thymol (thyme), eugenol (cloves), bourgeonal (floral, lily-of-the-valley), helional (brown algae) and substances present in roses, bananas or raspberries, specifically, caused an elevation of Ca2+ levels.
The findings suggest that these types of odorants may cause a serotonin-related GI reaction. The effects could be inhibited by known OR antagonists, such as methyl isoeugenol (a competitive antagonist of eugenol) or by blocking Ca2+ influx (e.g., via Ca2+ channels with nifedipine, a drug used in the treatment of hypertension because it relaxes blood vessels).
"Our results show that odorants present in the gut may stimulate serotonin release via olfactory receptors expressed in human enterochromaffin cells in the gut mucosa," said Petra Voland, Ph.D., of the Technical University of Munich, and one of the lead investigators of the study. "Serotonin controls peristalsis and is implicated in pathological conditions such as vomiting, diarrhea and irritable bowel syndrome. Thus, olfactory receptors are potential novel targets for the treatment of gastrointestinal diseases and motility disorders."
Dr. Voland will present this study on Wednesday, May 23, at 8:00 a.m. in Hall E.
Sacral Nerve Stimulation for Constipation: An International Multi-Centre Study (Abstract #198)
In patients with idiopathic constipation, which occurs with no identifiable cause, in whom conservative treatment has failed, surgical procedures (e.g., colectomy) are associated with a high failure rate and substantial morbidity. Researchers from five European sites set out to explore an alternative approach: modulating the extrinsic nerve supply to the bowel. In doing so, investigators evaluated the symptomatic response and physiological effect of sacral nerve stimulation in patients with slow transit constipation and normal transit constipation with impaired evacuation.
In this prospective, multi-center trial, 65 patients (58 female) who failed treatment with laxatives and biofeedback (retraining pelvic floor muscle coordination using exercises and electronic aids that create feedback when successful muscle contraction occur) underwent test stimulation, each serving as their own control. The effect of temporary sacral nerve stimulation was assessed by a 21-day bowel habit diary. Patients with more than 50 percent improvement in symptoms were eligible for permanent stimulation. Long-term results were assessed by: bowel habit diary, symptom questionnaire, Cleveland Clinic constipation score (CCCS), visual analogue score (VAS) and short form-36 (SF-36) quality of life questionnaire. Primary endpoints included an increase in the frequency of defecation, reduction in straining and reduction in the sensation of incomplete evacuation.
After a median follow up of 12 months, subjects with both slow transit and impaired evacuation benefited from therapy and 43 patients (66%) proceeded to chronic stimulation. Frequency of defecation increased from 3.4 to 6.1 times per week, while evacuation days per week increased from 2.4 to 4.4. Time spent in facilities decreased from 17.6 to 9.3 minutes, straining decreased from 4.4 to 2.9 episodes per week, abdominal pain decreased from 4.4 to 2.0 days per week, and perception of incomplete evacuation decreased significantly.
In evaluating the results of the various assessment tools set forth at the start of the trial, researchers found that: the CCCS (0=no constipation, 30=severe constipation) decreased from 18.0 to 10.2; mean VAS (0=severe symptoms, 100=no symptoms) increased from 18 to 66; and SF-36 subsets of physical functioning, general health, vitality, social functioning and mental health significantly improved.
"While constipation is rarely life-threatening, associated symptoms of abdominal pain, bloating and the sensation of incomplete evacuation can severely affect the physical and emotional well-being of patients. There are many treatment options for the condition and the best approach relies on a clear understanding of the underlying cause," said Thomas Dudding, M.D., of St. Mark's Hospital in London, England, and lead investigator for the study. "This study found that sacral nerve stimulation is an effective treatment for idiopathic constipation that is resistant to conservative treatment. As a result of this stimulation process, improvement occurs in bowel frequency, associated symptoms and overall quality of life."
Dr. Dudding will present this study on Sunday, May 20, at 2:15 p.m. in Room 151A.
American Gastroenterological Association
One primary research focus in GI disorders is how and why the system reacts to certain foods or other stimulants; specifically, researchers are investigating the primary factors responsible for regulating digestion. Enterochromaffin (EC) cells, which are present throughout the digestive system, release serotonin (a chemical associated with the etiology of various diseases such as migraine, diarrhea, respiratory disturbances and hypertension) and are important in regulating gut motility. Researchers from the Technical University of Munich and the Ludwig Maximillian University of Munich in Germany investigated whether EC cells in the intestine express nasal olfactory receptors (ORs, receptors used for smelling) to determine whether odorants present in spices, fragrances, cigarettes, detergents and cosmetics may cause serotonin release, thereby provoking a GI response.
To evaluate this connection, researchers studied human EC cells isolated from mucosal biopsies by laser microdissection and an EC derived cell line. The experiments revealed expression of several ORs in the isolated EC cells, as well as the cell line. Using digital fluorescence imaging, the team found that activation of the cells with odorants caused elevation of intracellular Ca2+, followed by serotonin release up to 10-fold that of the controls. Odorants like thymol (thyme), eugenol (cloves), bourgeonal (floral, lily-of-the-valley), helional (brown algae) and substances present in roses, bananas or raspberries, specifically, caused an elevation of Ca2+ levels.
The findings suggest that these types of odorants may cause a serotonin-related GI reaction. The effects could be inhibited by known OR antagonists, such as methyl isoeugenol (a competitive antagonist of eugenol) or by blocking Ca2+ influx (e.g., via Ca2+ channels with nifedipine, a drug used in the treatment of hypertension because it relaxes blood vessels).
"Our results show that odorants present in the gut may stimulate serotonin release via olfactory receptors expressed in human enterochromaffin cells in the gut mucosa," said Petra Voland, Ph.D., of the Technical University of Munich, and one of the lead investigators of the study. "Serotonin controls peristalsis and is implicated in pathological conditions such as vomiting, diarrhea and irritable bowel syndrome. Thus, olfactory receptors are potential novel targets for the treatment of gastrointestinal diseases and motility disorders."
Dr. Voland will present this study on Wednesday, May 23, at 8:00 a.m. in Hall E.
Sacral Nerve Stimulation for Constipation: An International Multi-Centre Study (Abstract #198)
In patients with idiopathic constipation, which occurs with no identifiable cause, in whom conservative treatment has failed, surgical procedures (e.g., colectomy) are associated with a high failure rate and substantial morbidity. Researchers from five European sites set out to explore an alternative approach: modulating the extrinsic nerve supply to the bowel. In doing so, investigators evaluated the symptomatic response and physiological effect of sacral nerve stimulation in patients with slow transit constipation and normal transit constipation with impaired evacuation.
In this prospective, multi-center trial, 65 patients (58 female) who failed treatment with laxatives and biofeedback (retraining pelvic floor muscle coordination using exercises and electronic aids that create feedback when successful muscle contraction occur) underwent test stimulation, each serving as their own control. The effect of temporary sacral nerve stimulation was assessed by a 21-day bowel habit diary. Patients with more than 50 percent improvement in symptoms were eligible for permanent stimulation. Long-term results were assessed by: bowel habit diary, symptom questionnaire, Cleveland Clinic constipation score (CCCS), visual analogue score (VAS) and short form-36 (SF-36) quality of life questionnaire. Primary endpoints included an increase in the frequency of defecation, reduction in straining and reduction in the sensation of incomplete evacuation.
After a median follow up of 12 months, subjects with both slow transit and impaired evacuation benefited from therapy and 43 patients (66%) proceeded to chronic stimulation. Frequency of defecation increased from 3.4 to 6.1 times per week, while evacuation days per week increased from 2.4 to 4.4. Time spent in facilities decreased from 17.6 to 9.3 minutes, straining decreased from 4.4 to 2.9 episodes per week, abdominal pain decreased from 4.4 to 2.0 days per week, and perception of incomplete evacuation decreased significantly.
In evaluating the results of the various assessment tools set forth at the start of the trial, researchers found that: the CCCS (0=no constipation, 30=severe constipation) decreased from 18.0 to 10.2; mean VAS (0=severe symptoms, 100=no symptoms) increased from 18 to 66; and SF-36 subsets of physical functioning, general health, vitality, social functioning and mental health significantly improved.
"While constipation is rarely life-threatening, associated symptoms of abdominal pain, bloating and the sensation of incomplete evacuation can severely affect the physical and emotional well-being of patients. There are many treatment options for the condition and the best approach relies on a clear understanding of the underlying cause," said Thomas Dudding, M.D., of St. Mark's Hospital in London, England, and lead investigator for the study. "This study found that sacral nerve stimulation is an effective treatment for idiopathic constipation that is resistant to conservative treatment. As a result of this stimulation process, improvement occurs in bowel frequency, associated symptoms and overall quality of life."
Dr. Dudding will present this study on Sunday, May 20, at 2:15 p.m. in Room 151A.
American Gastroenterological Association
Irritable Bowel Syndrome Current Events and Irritable Bowel Syndrome News RSSAntidepressant and placebo are equally effective in child pain relief
When used "off-label," the antidepressant amitriptyline works just as well as placebo in treating pain-predominant gastrointestinal disorders in children, according to a new study in Gastroenterology, the official journal of the American Gastroenterological Association (AGA) Institute.
What is alternative treatment for irritable bowel syndrome when conventional therapy has failed?
IBS remains a common intestinal disorder causing significant discomfort and poor quality of life in patients who have the diagnosis.
Pinpointing cause of colic: UT Houston research identifies organism that could trigger constant crying
Researchers at The University of Texas Health Science Center at Houston say one organism discovered during their study may unlock the key to what causes colic, inconsolable crying in an otherwise healthy baby.
Mayo Clinic study finds celiac disease 4 times more common than in 1950s
Celiac disease, an immune system reaction to gluten in the diet, is over four times more common today than it was 50 years ago, according to findings of a Mayo Clinic study published this month in the journal Gastroenterology.
Review of probiotic trial research finds only Bifantis able to claim efficacy for IBS symptoms
A review by researchers at Northwestern University (Chicago, IL.) and University of Michigan (Ann Arbor, MI) of the utility of probiotics in the treatment of Irritable Bowel Syndrome (IBS) found that Bifidobacterium infantis 35624 was the only probiotic strain out of 13 different individual strains or preparations reviewed to significantly improve symptoms of IBS, including abdominal pain, bloating and bowel movement difficulty.
New studies examine the effectiveness of probiotics in IBS
Several studies presented at the American College of Gastroenterology's 73rd Annual Scientific Meeting in Orlando highlight the safety and efficacy of probiotics in improving symptoms and normalizing bowel movement frequency in patients suffering from constipation or diarrhea related to Irritable Bowel Syndrome (IBS).
New study shows health benefits of probiotic could extend to the entire body
Data from a recent study demonstrate the anti-inflammatory and pathogen protection benefits of Bifidobacterium infantis 35624 a probiotic bacterial strain of human origin.
UT School of Public Health researchers discover significant efficacy of travelers' diarrhea vaccine
Researchers at The University of Texas School of Public Health have found that patients given a travelers' diarrhea vaccine were significantly less likely to suffer from clinically significant diarrhea than those who received placebo, according to a study published in this week's edition of the Lancet. The patch-based vaccine is part of the Phase 2 study in conjunction with the Iomai Corporation.
Common bowel problem linked to chili pepper pain receptor
People with irritable bowel syndrome have a higher than usual number of chilli pepper pain receptors, according to a new study published tomorrow (Wednesday 11 June).
Drug brings relief for many IBS patients who experience constipation
Many patients may soon find relief from the bloating, cramping, abdominal pain and constipation associated with irritable bowel syndrome, or IBS.
More Irritable Bowel Syndrome Current Events and Irritable Bowel Syndrome News Articles
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The First Year: IBS (Irritable Bowel Syndrome)--An Essential Guide for the Newly Diagnosed by Heather Van Vorous (Author), David B. Posner (Foreword) Heather Van Vorous has had IBS for over two decades; she endured the condition for six years as a child before even being diagnosed. Over many years she has educated herself on every aspect of this chronic condition—by listening to her own body, gradually modifying her diet, reading medical and scientific books and journals, talking with doctors, exploring stress management and alternative health therapies, and using the Internet to communicate daily with other people who have IBS. Now, as a "patient-expert," she guides all those newly diagnosed step-by-step through their first year with IBS. In a unique format, The First Year™—IBS walks you through everything you need to learn and do each day of your first week after diagnosis, each subsequent week of the first month, and the... |
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Irritable Bowel Syndrome: A Natural Approach by Rosemary Nicol (Author), M.D. William John Snape Jr. (Foreword) Clearly written with easy-to-understand explanations, this book presents natural solutions for living comfortably with this common ailment. It maintains that thoroughly addressing the causes of IBS—diet and stress—can effectively relieve symptoms without resorting to medication. The authors offer creative dietary alternatives and recipes as well as proven methods for controlling stress—including meditation, yoga, and relaxation exercises. |
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The Irritable Bowel Syndrome Solution: How It's Cured at the IBS Treatment Center by Stephen Wangen (Author) This is the authoritative resource on IBS. If you have IBS, constipation, diarrhea, gas, bloating, indigestion, or chronic abdominal pain, there is a logical reason for your suffering. Written by Dr. Stephen Wangen, the founder and Chief Medical Officer of the IBS Treatment Center, this book explains how your symptoms can be cured. You do not need to eat more fiber, take medications or supplements for the rest of your life, or wonder if you are too stressed. You can actually live you life completely free of IBS. In this book you will discover: · What actually causes IBS. · How to find the cause of your IBS symptoms. · Why most IBS treatments don’t address the causes of IBS. · How to treat IBS once you’ve found the cause. · Where to go for help. · How... |
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Digestive Advantage IBS - Irritable Bowel Syndrome, Capsules, 96-Count by Digestive Advantage Digestive Advantage IBS is for the dietary management of Irritable Bowel Syndrome. It is formulated to manage the full range of irritable bowel syndrome symptoms including diarrhea, constipation, bloating, cramps, and urgency. This unique formulation helps Digestive Advantage IBS normalize the gut and support a normal diet. Digestive Advantage IBS is a caplet taken once per day and provides 24-hour relief to Irritable Bowel Syndrome (IBS) symptoms. The power behind Digestive Advantage IBS is a patented blend of lactobacillus cultures with an amino acid which facillitates digestion of dairy, fruits, meats, and carbohydrates. Digestive Advantage IBS is unique because it helps to relieve both ends of the IBS spectrum: Diarrhea and Constipation. |
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Dynamic Diet: A Dietary Guide And Workbook For Patients With Irritable Bowel Syndrome by Ashkan Farhadi (Author), Kelly Wyckoff (Author) How to create your diet to manage your IBS. This handout and work book is designed to improve your overall knowledge about various aspects of your diet in Irritable Bowel Syndrome and to help you explore your dietary choices to build your own diet that best suits your condition. This common sense approach could be one of the most useful and least restrictive diet modifications you may select to manage your IBS. |
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Eating for IBS: 175 Delicious, Nutritious, Low-Fat, Low-Residue Recipes to Stabilize the Touchiest Tummy by Heather Van Vorous (Author) If you are one of the millions of people suffering from IBS, immediate help is finally at hand. Contrary to what many believe, eating for IBS does not mean deprivation, never going to restaurants, boring food, or a limited and therefore unhealthy diet. It does mean learning to eat safely by realizing how different foods physically affect the GI tract, and how these foods can prevent or trigger IBS. For example: * There are two kinds of fiber...one soothes the colon but the other can cause severe attacks * Dairy is a common trigger...even in people who are not lactose intolerant * Peppermint, chamomile, and fennel can prevent attacks better than some prescription drugs * Bland foods are not automatically safe foods In Eating for IBS, Heather Van Vorous, who... |
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Irritable Bowel Syndrome & the MindBodySpirit Connection: 7 Steps for Living a Healthy Life with a Functional Bowel Disorder, Crohn's Disease, or Colitis (Mind-Body-Spirit Connection Series.) by William B. Salt II MD (Author), Neil F. Neimark MD (Author) Fast Facts on IBS: One in five people suffers from the frustrating symptoms of Irritable Bowel Syndrome (IBS). There is no simple answer--no pill, potion, or quick fix--that will cure IBS. But help is available. By understanding what causes IBS and by integrating mind, body, and spirit into the treatment plan, readers can achieve health and wellness. They can move from pain to peace, from helplessness to hopefulness, and from frustration to freedom. Tap into the Body's Powerful Ability to Heal: The interrelationships between mind, body, and spirit are the forces that shape many health issues, especially for those suffering painful symptoms for which medical science does not find a discernible cause. IBS problems are painful and embarrassing, yet medical tests often find nothing abnormal.... |
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I Have IBS...Now What?!!! A Comprehensive Guide for Patients with Irritable Bowel Syndrome by Ashkan Farhadi (Author) The book, I Have IBS, Now What?!!! was written by Dr. Ashkan Farhadi, a leading gastroenterologist based in Chicago. Dr. Farhadi wrote this book as a resource for patients who were diagnosed with Irritable Bowel Syndrome (IBS). This new edition features the most up-to-date information on IBS including new advances in the field. This book compiles real patient questions posed to Dr. Farhadi over years of practice into a first rate guide for patients with IBS and also include the opinion of a group of experts in the field of gastroenterology with a special attention to the psychological and nutritional aspects of this common disorder. |
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Tell Me What to Eat If I Have Irritable Bowel Syndrome: Nutrition You Can Live With by Elaine Magee (Author), Christine L., Dr., M.D. Frissora (Foreword) Irritable Bowel Syndrome is one of the most common reasons for a visit to the doctor in the United States, Europe, and other parts of the Western world. Even so, the majority of patients who have IBS do not seek medical care, which may be because of fear, embarrassment, or the lack of effective treatments. IBS affects both genders and all races. Recent data shows that 14 to 24 percent of women and 5 to 19 percent of men in the United States and Great Britain have IBS. If you have IBS, you are undoubtedly familiar with the link between your condition, your comfort, and what you eat or drink. Elaine Magee gives you positive advice about what foods you should eat almost every day, and whether you suffer from IBS constipation, IBS diarrhea predominant, or the type of IBS that... |
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Heather's Tummy Fiber POUCH ~ Organic Acacia Senegal 16 oz. for Irritable Bowel Syndrome by Heather's Tummy Care Heather's Tummy Fiber™ ~ Organic Acacia is a medical food for the dietary management of Irritable Bowel Syndrome symptoms. Acacia is a natural, pure, organic, soluble dietary fiber produced from the gum of the Acacia tree. Clinical studies have shown that soluble fiber, as part of the diet: helps soothe and regulate bowel motility; relieves IBS abdominal pain and cramping by stabilizing intestinal contractions; alleviates BOTH diarrhea and constipation. Heather's Tummy Fiber™ also: increases good gut flora - it's considered a prebiotic; has excellent gastrointestinal tolerance; and slows down colonic fermentation, which in turn decreases gas and bloating. Heather's Tummy Fiber™ is completely safe and healthy for daily, lifelong use, is safe for use in children, and has no GI... |
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