text:
@article{
   author = {Azriel Mira, S. and Requejo Salinas, H. and Garcia Fernandez, E. and Hawkins Carranza, F.},
   title = {Diabetes and diarrhea in an elderly woman},
   journal = {Endocrinol Nutr},
   volume = {55},
   number = {5},
   pages = {226-9},
   note = {Azriel Mira, Sharona
Requejo Salinas, Helena
Garcia Fernandez, Elena
Hawkins Carranza, Federico
Journal Article
Spain
Endocrinol Nutr. 2008 May;55(5):226-9. Epub 2008 Oct 15.},
   abstract = {Between 5 and 10% of adults initially diagnosed with type 2 diabetes mellitus.(DM) actually have adult-onset autoimmune diabetes. Given the large number of patients diagnosed with DM type 2, the entity called latent autoimmune diabetes in adults (LADA) by some authors could represent half of all diabetics with type 1A diabetes. We report the case of a 75-year-old woman, with a history of brittle diabetes and irritable bowel syndrome, who was finally diagnosed with autoimmune diabetes and celiac disease.},
   ISSN = {1575-0922 (Print)
1575-0922},
   Accession Number = {22967917},
   DOI = {10.1016/s1575-0922(08)70672-7},
   year = {2008},
   type = {Ref–rence Type}
}

@article{
   author = {Baber, K. F. and Anderson, J. and Puzanovova, M. and Walker, L. S.},
   title = {Rome II versus Rome III classification of functional gastrointestinal disorders in pediatric chronic abdominal pain},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {47},
   number = {3},
   pages = {299-302},
   note = {1536-4801
Baber, Kari F
Anderson, Julia
Puzanovova, Martina
Walker, Lynn S
R01 HD023264/HD/NICHD NIH HHS/United States
R01 HD023264-19/HD/NICHD NIH HHS/United States
HD23264/HD/NICHD NIH HHS/United States
Journal Article
Research Support, N.I.H., Extramural
United States
J Pediatr Gastroenterol Nutr. 2008 Sep;47(3):299-302. doi: 10.1097/MPG.0b013e31816c4372.},
   abstract = {OBJECTIVES: The updated Rome III criteria for pediatric functional gastrointestinal disorders (FGIDs) include new FGID categories and changes to the Rome II criteria for various FGIDs. To our knowledge, the implications of these revisions for patient classification have not been identified. The purpose of this study was to compare classification results using Rome II versus Rome III criteria for FGIDs associated with chronic abdominal pain. PATIENTS AND METHODS: Participants were 368 pediatric patients whose subspecialty evaluations for chronic abdominal pain yielded no evidence of organic disease. The children's gastrointestinal symptoms were assessed with the parent-report version of the Questionnaire on Pediatric Gastrointestinal Symptoms (QPGS). RESULTS: More patients met the criteria for a pediatric pain-related FGID according to the Rome III criteria (86.6%) than the Rome II criteria (68.0%). In comparison with the results from the Rome II criteria, the Rome III criteria classified a greater percentage of children as meeting criteria for Abdominal Migraine (23.1% vs 5.7%) and Functional Abdominal Pain (11.4% vs 2.7%). Irritable Bowel Syndrome was the most common diagnosis according to both Rome II (44.0%) and Rome III (45.1%). CONCLUSIONS: Changes to the Rome criteria make the Rome III criteria more inclusive, allowing classification of 86.6% of pediatric patients with medically unexplained chronic abdominal pain.},
   keywords = {Abdominal Pain/classification/*diagnosis/*etiology
Child
Diagnosis, Differential
Dyspepsia/classification/diagnosis
Female
Gastrointestinal Diseases/*classification/*diagnosis
Humans
Irritable Bowel Syndrome/classification/diagnosis
Male
Migraine Disorders/classification/diagnosis
Parents/psychology
Severity of Illness Index
Surveys and Questionnaires},
   ISSN = {0277-2116},
   Accession Number = {18728525},
   DOI = {10.1097/MPG.0b013e31816c4372},
   year = {2008},
   type = {Ref–rence Type}
}

@article{
   author = {Bahar, R. J. and Collins, B. S. and Steinmetz, B. and Ament, M. E.},
   title = {Double-blind placebo-controlled trial of amitriptyline for the treatment of irritable bowel syndrome in adolescents},
   journal = {J Pediatr},
   volume = {152},
   number = {5},
   pages = {685-9},
   note = {1097-6833
Bahar, Ron J
Collins, Brynie S
Steinmetz, Barry
Ament, Marvin E
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
United States
J Pediatr. 2008 May;152(5):685-9. doi: 10.1016/j.jpeds.2007.10.012. Epub 2008 Feb 20.},
   abstract = {OBJECTIVES: To determine the efficacy of amitriptyline (AMI) in treating irritable bowel syndrome (IBS) in adolescents. STUDY DESIGN: Adolescents 12 to 18 years with newly diagnosed IBS were surveyed with a symptom checklist, pain rating scale, visual analog scale, and IBS quality of life (QOL) questionnaire. Subjects were randomized in a double-blinded fashion to receive AMI or placebo, and again completed surveys at 2, 6, 10, and 13 weeks. RESULTS: Thirty-three patients (24 female) were enrolled. Patients receiving AMI were more likely to experience improvement from baseline in overall QOL at 6, 10, and 13 weeks (P = .019, .004, and .013). Patients receiving AMI were also more likely to experience a reduction in IBS-associated diarrhea at 6 and 10 weeks (P = .029 for both), a reduction in periumbilical pain at 10 weeks (P = .018), and a reduction in right lower quadrant pain at 6, 10, and 13 weeks (P = .014, .039, and .004). CONCLUSION: AMI significantly improves overall QOL in adolescents with IBS and should be a therapeutic option for adolescents with this disorder.},
   keywords = {Abdominal Pain/etiology/prevention & control
Adolescent
Amitriptyline/*therapeutic use
Antidepressive Agents, Tricyclic/*therapeutic use
Double-Blind Method
Female
Humans
Irritable Bowel Syndrome/complications/*drug therapy/psychology
Male
Pain Measurement
Prospective Studies
Quality of Life
Treatment Outcome},
   ISSN = {0022-3476},
   Accession Number = {18410774},
   DOI = {10.1016/j.jpeds.2007.10.012},
   year = {2008},
   type = {Ref–rence Type}
}

@article{
   author = {Barreau, F. and Salvador-Cartier, C. and Houdeau, E. and Bueno, L. and Fioramonti, J.},
   title = {Long-term alterations of colonic nerve-mast cell interactions induced by neonatal maternal deprivation in rats},
   journal = {Gut},
   volume = {57},
   number = {5},
   pages = {582-90},
   note = {1468-3288
Barreau, F
Salvador-Cartier, C
Houdeau, E
Bueno, L
Fioramonti, J
Journal Article
England
Gut. 2008 May;57(5):582-90. doi: 10.1136/gut.2007.126680. Epub 2008 Jan 14.},
   abstract = {BACKGROUND: Neonatal maternal deprivation induces colonic alterations in adult rats, such as hypersensitivity to distension or an increase in paracellular permeability, characteristics of irritable bowel syndrome (IBS) patients. Recent studies described neuroimmune alterations in the colonic mucosa of IBS patients. METHODS: Male Wistar rats were submitted to maternal deprivation for 3 h daily during postnatal days 2-14, and were sacrificed at 4 or 12 weeks of age. Control pups were left undisturbed with their dam. RESULTS: Colonic mast cell hyperplasia was observed at 4 and 12 weeks in maternally deprived rats, and was associated with an increase in protease content. Mucosal nerve fibre density assessed by protein gene product (PGP) 9.5 immunoreactivity was increased at 12 weeks but not at 4 weeks, while calcitonin gene-related protein (CGRP)-immunoreactive fibres remain constant. Synaptogenesis assessed by synaptophysin immunostaining was increased at 4 weeks but not at 12 weeks. The number of mast cells in close proximity to PGP 9.5- or CGRP-immunoreactive fibres was greater at both 4 and 12 weeks. Expression of neurokinin NK(1) receptors in the spinal cord was enhanced at 12 weeks. No significant change in total mast cell number, PGP 9.5 immunoreactivity and mast cells associated with PGP 9.5-immunoreactive fibres was observed in the jejunum. Treatment of pups with anti-nerve growth factor (NGF) antibodies abolished the increases in synaptogenesis and in the number of mast cells in close proximity to nerve fibres observed 4 weeks after maternal deprivation. CONCLUSIONS: Neonatal maternal deprivation induces closer association of colonic mast cells with nerves, which is similar to that seen in IBS patients. NGF is a possible mediator of this effect.},
   keywords = {Animals
Animals, Newborn
Antibodies, Monoclonal/pharmacology
Calcitonin Gene-Related Peptide/antagonists & inhibitors
Cell Communication/physiology
Colon/*innervation/pathology/physiopathology
Hyperplasia
Intestinal Mucosa/metabolism/pathology/physiopathology
Irritable Bowel Syndrome/*etiology/pathology
Jejunum/metabolism/pathology/*physiopathology
Male
Mast Cells/metabolism/*physiology
*Maternal Deprivation
Metalloendopeptidases/metabolism
Nerve Fibers/physiology
Nerve Growth Factor/antagonists & inhibitors/immunology
Rats
Rats, Wistar
Receptors, Neurokinin-1/metabolism
Spinal Cord/metabolism},
   ISSN = {0017-5749},
   Accession Number = {18194988},
   DOI = {10.1136/gut.2007.126680},
   year = {2008},
   type = {Ref–rence Type}
}

@article{
   author = {Bueno, L. and Fioramonti, J.},
   title = {Protease-activated receptor 2 and gut permeability: a review},
   journal = {Neurogastroenterol Motil},
   volume = {20},
   number = {6},
   pages = {580-7},
   note = {1365-2982
Bueno, L
Fioramonti, J
Journal Article
Review
England
Neurogastroenterol Motil. 2008 Jun;20(6):580-7. doi: 10.1111/j.1365-2982.2008.01139.x.},
   abstract = {Digestive tract proteases are best known for their proteolytic activity in the digestion of alimentary proteins. However, during the last decade, a possible role of proteases as signalling molecules has been emphasized with the discovery of a novel class of G-protein coupled receptors located on cell membranes that may be activated by proteolytic cleavage of their N-terminal extracellular domain. Type 2 protease-activated receptors (PAR-2) are cleaved by serine-proteases such as trypsin and tryptase. PAR-2 is present in many intestinal cell types and particularly on epithelial cells. Multiple functions have been demonstrated in the gut for PAR-2, including epithelial permeability, mainly the intercellular permeability that is of paramount importance in the equilibrium between the external milieu (digestive contents) and the submucosal immune system. Alterations of both tissue and luminal levels of proteases or serine-protease activity may affect gut permeability and subsequently the immune status of the mucosa. Activation of PAR-2 on epithelial cells may directly affect cytoskeleton contraction by triggering phosphorylation of myosin light chain with subsequent changes in tight junction permeability. Enhanced fecal protease level has been recently reported in both organic (ulcerative colitis) and functional (irritable bowel syndrome) intestinal disorders and may play a role in the pathogenesis of such diseases.},
   keywords = {Animals
Cell Membrane Permeability/*physiology
Extracellular Fluid/enzymology
Gastrointestinal Diseases/diagnosis/enzymology/physiopathology
Gastrointestinal Tract/*enzymology/physiology
Humans
Intestinal Absorption/*physiology
Intestinal Mucosa/*enzymology
Receptor, PAR-2/metabolism/*physiology},
   ISSN = {1350-1925},
   Accession Number = {18482083},
   DOI = {10.1111/j.1365-2982.2008.01139.x},
   year = {2008},
   type = {Ref–rence Type}
}

@article{
   author = {Bursch, B.},
   title = {Psychological/cognitive behavioral treatment of childhood functional abdominal pain and irritable bowel syndrome},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {47},
   number = {5},
   pages = {706-7},
   note = {1536-4801
Bursch, Brenda
Journal Article
United States
J Pediatr Gastroenterol Nutr. 2008 Nov;47(5):706-7. doi: 10.1097/01.mpg.0000338967.47679.e9.},
   keywords = {Abdominal Pain/*psychology
*Behavior Therapy
Child
Cognition
Humans
Irritable Bowel Syndrome/*psychology
Psychology, Adolescent
Psychology, Child
*Psychotherapy},
   ISSN = {0277-2116},
   Accession Number = {18955885},
   DOI = {10.1097/01.mpg.0000338967.47679.e9},
   year = {2008},
   type = {Ref–rence Type}
}

@article{
   author = {Carey, C. M. and Kirk, J. L. and Ojha, S. and Kostrzynska, M.},
   title = {Current and future uses of real-time polymerase chain reaction and microarrays in the study of intestinal microbiota, and probiotic use and effectiveness},
   journal = {Can J Microbiol},
   volume = {53},
   number = {5},
   pages = {537-50},
   note = {Carey, Christine M
Kirk, Jennifer L
Ojha, Shivani
Kostrzynska, Magdalena
Journal Article
Research Support, Non-U.S. Gov't
Review
Canada
Can J Microbiol. 2007 May;53(5):537-50.},
   abstract = {Probiotics are defined as live microorganisms that confer a health benefit to the host when administered in adequate amounts. In addition to human health benefits, probiotics can improve various aspects of growth and performance in livestock and poultry, as well as control undesirable microorganisms in food animals. Studies indicate that probiotics can prevent or treat certain conditions, including atopic disease in infants, food allergy, infection after surgery, acute diarrhea, and symptoms associated with irritable bowel syndrome. Understanding the complete mechanism, effectiveness, and potential use of probiotics is limited by the availability and sensitivity of current methods (i.e., culturing techniques). In recent years, real-time polymerase chain reaction (PCR) and microarrays have become prominent and promising methods to examine quantitative changes of specific members of the microbial community and the influence of probiotics on the structure and function of human and animal intestinal ecosystems. Culture-independent studies have established that only a fraction of organisms present in feces are cultivable, therefore, results obtained by cultivation are limited. Conversely, in-depth knowledge of microbial genomes has enabled real-time PCR and microarrays to be more sensitive and has resulted in precise methods for comprehensive analysis of the complex gut microbiota. Additionally, these technologies can assess the influence of intestinal microorganisms on host metabolism, nutrient status, and disease. This paper reviews method technologies and applications of real-time PCR and microarray assays as they relate to the effect and use of probiotics on the intestinal microbiota and gastrointestinal disease.},
   keywords = {Animals
Humans
Intestines/*microbiology
Oligonucleotide Array Sequence Analysis/*methods
Probiotics/*administration & dosage/pharmacology/therapeutic use
Reverse Transcriptase Polymerase Chain Reaction/*methods},
   ISSN = {0008-4166 (Print)
0008-4166},
   Accession Number = {17668012},
   DOI = {10.1139/w07-039},
   year = {2007},
   type = {Ref–rence Type}
}

@article{
   author = {Castilloux, J. and Noble, A. and Faure, C.},
   title = {Is visceral hypersensitivity correlated with symptom severity in children with functional gastrointestinal disorders?},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {46},
   number = {3},
   pages = {272-8},
   note = {1536-4801
Castilloux, Julie
Noble, Angela
Faure, Christophe
Journal Article
United States
J Pediatr Gastroenterol Nutr. 2008 Mar;46(3):272-8. doi: 10.1097/MPG.0b013e31814b91e7.},
   abstract = {BACKGROUND: Abdominal pain related to irritable bowel syndrome (IBS) and functional abdominal pain (FAP) is frequent in children and can be of variable severity. Both IBS and FAP are associated with rectal hypersensitivity. We hypothesized that in children with IBS and FAP, the rectal sensory threshold for pain (RSTP) is associated with symptom severity. PATIENTS AND METHODS: A total of 47 patients (34 girls; median age, 14.2 years) with IBS (n = 29) and FAP (n = 18), according to the Rome II criteria, underwent a rectal barostat examination to determine their RSTP. Gastrointestinal symptom severity was assessed by validated questionnaires. During the rectal barostat exam, symptoms were documented using a visual analog scale and by measuring the area coloured on a human body diagram corresponding to painful sensations. RESULTS: The median RSTP was 16 mmHg and was similar in IBS and FAP patients. Eighty-three percent of the patients had rectal hypersensitivity (RSTP < or = 30.8 mmHg, the 5th percentile of control children studied in our laboratory). Fifty-one percent and 36%, respectively, reported missing school and social activities at least once per week. Increased frequency of pain, missed days of school, missed social activities, and pain during the barostat examination were not associated with lower RSTP values in either the whole group or in the subset of children with rectal hypersensitivity. CONCLUSIONS: Rectal hypersensitivity is not proportional to the severity of symptoms in children with IBS and FAP, indicating that symptom severity is influenced by other factors in addition to visceral hypersensitivity.},
   keywords = {Abdominal Pain/diagnosis/*pathology
Adolescent
Child
Dilatation
Female
Gastrointestinal Diseases/diagnosis/*pathology
Humans
Irritable Bowel Syndrome/diagnosis/*pathology
Male
Nociceptors/physiopathology
Pain Measurement
Pain Threshold
Rectum/*innervation/pathology
Sensation
Sensory Thresholds
Severity of Illness Index
Surveys and Questionnaires
Viscera/*innervation/pathology},
   ISSN = {0277-2116},
   Accession Number = {18376243},
   DOI = {10.1097/MPG.0b013e31814b91e7},
   year = {2008},
   type = {Ref–rence Type}
}

@article{
   author = {Catassi, C. and Kryszak, D. and Louis-Jacques, O. and Duerksen, D. R. and Hill, I. and Crowe, S. E. and Brown, A. R. and Procaccini, N. J. and Wonderly, B. A. and Hartley, P. and Moreci, J. and Bennett, N. and Horvath, K. and Burk, M. and Fasano, A.},
   title = {Detection of Celiac disease in primary care: a multicenter case-finding study in North America},
   journal = {Am J Gastroenterol},
   volume = {102},
   number = {7},
   pages = {1454-60},
   note = {Catassi, Carlo
Kryszak, Deborah
Louis-Jacques, Otto
Duerksen, Donald R
Hill, Ivor
Crowe, Sheila E
Brown, Andrew R
Procaccini, Nicholas J
Wonderly, Brigid A
Hartley, Paul
Moreci, James
Bennett, Nathan
Horvath, Karoly
Burk, Margaret
Fasano, Alessio
DK-48373/DK/NIDDK NIH HHS/United States
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
United States
Am J Gastroenterol. 2007 Jul;102(7):1454-60. Epub 2007 Mar 13.},
   abstract = {BACKGROUND: Celiac disease (CD) is one of the most common lifelong disorders in western countries. However, most cases remain currently undiagnosed in North America, mostly due to poor awareness of CD by primary care physicians. OBJECTIVES: The aims of this study were (a) to determine whether an active case-finding strategy in primary care could increase the frequency of CD diagnosis and (b) to determine the most common clinical presentations of the condition. METHODS: This was a multicenter, prospective study involving adult subjects during the years 2002-2004, attending one of the participating practices. All individuals with symptoms or conditions known to be associated with CD were tested for immunoglobulin A anti-transglutaminase (tTG) antibodies, and those with elevated anti-tTG were subsequently tested for IgA antiendomysial antibodies (EMA). All subjects who were positive for EMA were advised to undergo an intestinal biopsy and HLA typing. RESULTS: The study group included 737 women and 239 men, with a median age of 54.3 yr. A positive anti-tTG test was found in 30 out of 976 investigated subjects (3.07%, 95% CI 1.98-4.16). CD was diagnosed in 22 patients (18 women, 4 men). The most frequent reasons for CD screening in these 22 cases were bloating (12/22), thyroid disease (11/22), irritable bowel syndrome (7/22), unexplained chronic diarrhea (6/22), chronic fatigue (5/22), and constipation (4/22). The prevalence of CD in the serologically screened sample was 2.25% (95% CI 1.32-3.18). The diagnostic rate was low at baseline (0.27 cases per thousand visits, 95% CI 0.13-0.41) and significantly increased to 11.6 per thousand visits (95% CI 6.8-16.4, P < 0.001) following active screening implementation. CONCLUSIONS: This study demonstrates that an active case-finding strategy in the primary care setting is an effective means to improve the diagnostic rate of CD in North America.},
   keywords = {Adolescent
Adult
Aged
Aged, 80 and over
Antibodies, Anti-Idiotypic/analysis
Biopsy
Celiac Disease/*diagnosis/epidemiology/genetics
DNA/analysis
Enzyme-Linked Immunosorbent Assay
Female
Follow-Up Studies
Genotype
HLA-DQ Antigens/immunology
Histocompatibility Testing
Humans
Immunoglobulin A/immunology
Incidence
Intestinal Mucosa/pathology
Male
Mass Screening/methods
Middle Aged
North America/epidemiology
Physicians, Family/standards
Primary Health Care/*methods
Prospective Studies
Transglutaminases/immunology},
   ISSN = {0002-9270 (Print)
0002-9270},
   Accession Number = {17355413},
   DOI = {10.1111/j.1572-0241.2007.01173.x},
   year = {2007},
   type = {Ref–rence Type}
}

@article{
   author = {Clark, C. and DeLegge, M.},
   title = {Irritable bowel syndrome: a practical approach},
   journal = {Nutr Clin Pract},
   volume = {23},
   number = {3},
   pages = {263-7},
   note = {Clark, Christian
DeLegge, Mark
Case Reports
Journal Article
Review
United States
Nutr Clin Pract. 2008 Jun-Jul;23(3):263-7. doi: 10.1177/0884533608318107.},
   abstract = {Irritable bowel syndrome accounts for approximately 2.7 million physician office visits yearly, although only 10%-30% of affected patients seek treatment. The disease is predominantly found in women 20-50 years of age. The etiology of irritable bowel syndrome is likely multifactorial: environmental factors, genetics, gut flora alterations, nervous system alterations (visceral hypersensitivity and motility abnormalities), and psychosocial stressors are thought to contribute. Treatment options are also quite diverse, including both pharmacologic and nonpharmacologic modalities. This article summarizes the proposed pathophysiology of and treatment options for irritable bowel syndrome.},
   keywords = {Adrenergic Uptake Inhibitors/therapeutic use
Adult
Autonomic Nervous System/*physiopathology
Combined Modality Therapy
Diagnosis, Differential
Environment
Female
Gastrointestinal Motility/physiology
Gastrointestinal Tract/innervation/microbiology/physiology
Genetic Predisposition to Disease
Humans
Hypothalamo-Hypophyseal System/*physiopathology
*Irritable Bowel Syndrome/diagnosis/epidemiology/etiology/therapy
Nortriptyline/therapeutic use
Pituitary-Adrenal System/*physiopathology
Prevalence},
   ISSN = {0884-5336 (Print)
0884-5336},
   Accession Number = {18595858},
   DOI = {10.1177/0884533608318107},
   year = {2008},
   type = {Ref–rence Type}
}

@article{
   author = {Crandall, W. V. and Halterman, T. E. and Mackner, L. M.},
   title = {Anxiety and pain symptoms in children with inflammatory bowel disease and functional gastrointestinal disorders undergoing colonoscopy},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {44},
   number = {1},
   pages = {63-7},
   note = {1536-4801
Crandall, Wallace V
Halterman, Timothy E
Mackner, Laura M
Comparative Study
Journal Article
United States
J Pediatr Gastroenterol Nutr. 2007 Jan;44(1):63-7.},
   abstract = {OBJECTIVE: To compare pain and anxiety scores between children with inflammatory bowel disease (IBD) and those with functional gastrointestinal disorders (FGID) undergoing colonoscopy and to examine the role of anxiety and procedure length in predicting reports of pain. MATERIALS AND METHODS: Children ages 10 to 18 years undergoing colonoscopy (general anesthesia) for the first time completed pain and anxiety questionnaires immediately before the procedure and a pain questionnaire 48 hours after colonoscopy. The diagnosis was determined by chart review and physician interview. RESULTS: Children with FGID had a longer duration of pain than those with IBD. Children with FGID endorsed a greater total number of the pain descriptors. The FGID group reported higher usual pain severity and greater postprocedural pain. No differences in anxiety were reported. However, higher levels of anxiety were associated with higher pain scores at the time of colonoscopy in children with IBD. It required significantly more time to perform colonoscopy in the IBD group than in the FGID group. Longer procedure duration was positively correlated with pain in children with FGID but not in children with IBD. CONCLUSIONS: Children with FGID report more usual pain symptoms and may describe more pain after a colonoscopy when compared with children with IBD. Anxiety appears to play a role in pain severity after colonoscopy in children presenting with IBD, but not in children with FGID.},
   keywords = {Abdominal Pain/etiology/psychology
Adolescent
Anxiety/*etiology
Child
*Colonoscopy
Dyspepsia/complications/diagnosis/psychology
Female
Gastrointestinal Diseases/*complications/diagnosis/*psychology
Humans
Inflammatory Bowel Diseases/complications/diagnosis/psychology
Irritable Bowel Syndrome/complications/diagnosis/psychology
Male
Pain/*etiology
Time Factors},
   ISSN = {0277-2116},
   Accession Number = {17204955},
   DOI = {10.1097/01.mpg.0000239733.79487.1e},
   year = {2007},
   type = {Ref–rence Type}
}

@article{
   author = {Davidson, G. and Kritas, S. and Butler, R.},
   title = {Stressed mucosa},
   journal = {Nestle Nutr Workshop Ser Pediatr Program},
   volume = {59},
   pages = {133-42; discussion 143-6},
   note = {Davidson, Geoffrey
Kritas, Stamatiki
Butler, Ross
Journal Article
Review
Switzerland
Nestle Nutr Workshop Ser Pediatr Program. 2007;59:133-42; discussion 143-6.},
   abstract = {Stress has been defined as an acute threat to the homeostasis of the organism. The mucosal lining of the gastrointestinal tract, a single layer of epithelial cells held together by tight junctions, provides a barrier between the external environment and the body's internal milieu. Any mechanism that breaches the tight junction exposes the body to foreign material be it protein, microorganisms or toxins. Stresses include physiological (exercise), psychological, disease-related or drug-induced factors. Stress associated gastrointestinal disorders include functional dyspepsia irritable bowel syndrome (IBS), gastroesophageal reflux disease peptic ulcer disease, and inflammatory bowel disease (IBD). Some disease states disrupt gastrointestinal barrier function, e.g. infectious diarrhea, IBD, or celiac disease, whilst in others such as eczema it can be indirectly related to antigenic disruption of the barrier. Drugs, e.g. chemotherapy agents and nonsteroidal anti-inflammatory drugs, also disrupt barrier function. Malnutrition and nutritional deficiencies (zinc, folic acid, vitamin A) also predispose to mucosal damage. Assessment of gastrointestinal mucosal health has proved problematic as invasive techniques, whilst useful, provide limited data and no functional assessment. Noninvasive tests particularly breath tests do provide functional assessment and many can be used together as biomarkers to improve our ability to define a stressed mucosa. Therapeutic options include pharmacotherapies, immunomodulation or immunotherapy.},
   keywords = {Biomarkers/analysis
Breath Tests
Child
Child, Preschool
Deficiency Diseases/pathology/*physiopathology
Humans
Infant
Infant, Newborn
Intestinal Diseases/diagnosis/*etiology/immunology/pathology
Intestinal Mucosa/*pathology
Malnutrition/pathology/*physiopathology
Stress, Physiological/pathology/*physiopathology},
   ISSN = {1661-6677 (Print)
1661-6677},
   Accession Number = {17245096},
   DOI = {10.1159/000098532},
   year = {2007},
   type = {Ref–rence Type}
}

@article{
   author = {Ducrotte, P.},
   title = {[Irritable bowel syndrome: current treatment options]},
   journal = {Presse Med},
   volume = {36},
   number = {11 Pt 2},
   pages = {1619-26},
   note = {Ducrotte, Philippe
English Abstract
Journal Article
Review
France
Presse Med. 2007 Nov;36(11 Pt 2):1619-26. Epub 2007 May 8.},
   abstract = {Relieving abdominal pain is the principal treatment objective for patients with irritable bowel syndrome. No single drug stands out in the treatment strategy for this illness. Antispasmodics, magnesium aluminum silicates, and alverine citrate drugs all remain initial options for treatment, although their prescription is impeded by the fact that an increasing number are no longer approved for reimbursement. Increased dietary fibers often have a harmful effect on symptoms. Some patients are probably intolerant to some foods but there is no satisfactory proof on which to base a restrictive diet. Improved knowledge of the pathophysiology of irritable bowel syndrome has made it possible to diversify treatments that act first on one of the key pathophysiologic elements, visceral hypersensitivity. Antidepressants (especially tricyclics) can be used at low doses. Among the serotonergic drugs, serotonin 5-HT4 receptors agonists (tegaserod) may be available soon, but the development of 5-HT3 antagonists (alosetron, cilansetron) has been stopped for safety reasons (ischemic colitis and severe constipation). Non-drug options such as hypnosis, psychotherapy, relaxation, or yoga, may also be proposed to some patients. Probiotics are a possible treatment in the future.},
   keywords = {Antidepressive Agents/therapeutic use
Humans
Irritable Bowel Syndrome/immunology/*therapy
Serotonin Receptor Agonists/therapeutic use},
   ISSN = {0755-4982 (Print)
0755-4982},
   Accession Number = {17490849},
   DOI = {10.1016/j.lpm.2007.03.008},
   year = {2007},
   type = {Ref–rence Type}
}

@article{
   author = {Dughera, L. and Elia, C. and Navino, M. and Cisaro, F.},
   title = {Effects of symbiotic preparations on constipated irritable bowel syndrome symptoms},
   journal = {Acta Biomed},
   volume = {78},
   number = {2},
   pages = {111-6},
   note = {Dughera, Luca
Elia, Chiara
Navino, Monica
Cisaro, Fabio
ARMONIA Study Group
Clinical Trial
Comparative Study
Journal Article
Multicenter Study
Italy
Acta Biomed. 2007 Aug;78(2):111-6.},
   abstract = {BACKGROUND: Prebiotic and probiotic therapies are new strategies that are being used to treat different gastrointestinal diseases, such as irritable bowel syndrome, diverticular disease and inflammatory bowel diseases. AIMS: Evaluating the effects of a symbiotic preparation on symptoms and colonic transit in patients with irritable bowel syndrome and significant bloating. METHODS: We carried out an open-label, prospective, uncontrolled, multicenter trial on 129 patients meeting Rome II criteria for irritable bowel syndrome who did not have lactose malabsorption, abdominal surgery, overt psychiatric disorders and ongoing psychotropic drug therapy or ethanol abuse. For three months, the patients were treated with a symbiotic preparation and were investigated trough questionnaires on symptoms. Data on bloating and abdominal pain were obtained using the McNemar-Bowker's test, while data on stool frequency were evaluated using the t-test. RESULTS: The administration of a symbiotic preparation to these patients modified the clinical picture and intestinal function, with a significant increase of stool frequency. CONCLUSIONS: Our data, although the study had an open design, represent a further analysis of positive symbiotic effects on clinical manifestations and intestinal function in patients with irritable bowel syndrome.},
   keywords = {Adult
*Bifidobacterium
Colon/physiology
Constipation/*therapy
Female
Gastrointestinal Transit
Humans
Irritable Bowel Syndrome/diagnosis/physiopathology/*therapy
Male
Middle Aged
Probiotics/administration & dosage/*therapeutic use
Prospective Studies
Surveys and Questionnaires
Time Factors
Treatment Outcome},
   ISSN = {0392-4203 (Print)
0392-4203},
   Accession Number = {17933278},
   year = {2007},
   type = {Ref–rence Type}
}

@article{
   author = {Eder, P. and Stawczyk-Eder, K. and Krela-Kazmierczak, I. and Linke, K.},
   title = {Clinical utility of the assessment of fecal calprotectin in Lesniowski-Crohn's disease},
   journal = {Pol Arch Med Wewn},
   volume = {118},
   number = {11},
   pages = {622-6},
   note = {Eder, Piotr
Stawczyk-Eder, Kamila
Krela-Kazmierczak, Iwona
Linke, Krzysztof
Journal Article
Research Support, Non-U.S. Gov't
Poland
Pol Arch Med Wewn. 2008 Nov;118(11):622-6.},
   abstract = {INTRODUCTION: From the epidemiological point of view, Lesniowski-Crohn's disease (CD) has become an important medical problem. It is essential to differentiate CD from functional disorders of the gastrointestinal tract, first of all, from irritable bowel syndrome (IBS). There are no simple, non-invasive tests available which could help to identify patients with common symptoms such as abdominal pain or diarrhea who should be referred for further evaluation, including endoscopy. OBJECTIVES: The aim of this study was to evaluate the diagnostic utility of the assessment of fecal calprotectin concentration in patients with CD. PATIENTS AND METHODS: Stool samples were taken from 31 patients of the Gastroenterology, Human Nutrition and Internal Diseases Department of Poznan Medical University who were diagnosed with CD. Patients suffering from IBS served as the control group. Calprotectin concentration was assessed by means of the immunoenzymatic ELISA method. Serum C-reactive protein (CRP) concentration and blood cell count were determined. The clinical activity of CD was assessed by means of Crohn's Disease Activity Index. An appropriate statistical analysis was performed. RESULTS: Mean calprotectin concentration in CD group was 32.01 +/- 22.58 mg/l and it was statistically higher (p <0.0003) than among IBS patients. A concentration of 16.01 mg/l had 67.7% sensitivity and 66.7% specificity in distinguishing between CD and IBS. There was a positive correlation between calprotectin concentration and CRP, and negative--with hemoglobin concentration. CONCLUSIONS: The assessment of fecal calprotectin concentration may be useful in differential diagnoses of CD and monitoring patients with CD.},
   keywords = {Adult
Biomarkers/analysis
C-Reactive Protein/analysis
Case-Control Studies
Crohn Disease/*diagnosis/metabolism
Diagnosis, Differential
Enzyme-Linked Immunosorbent Assay
Feces/*chemistry
Female
Humans
Inflammatory Bowel Diseases/diagnosis/metabolism
Leukocyte L1 Antigen Complex/*analysis
Male
Middle Aged
Predictive Value of Tests
Severity of Illness Index},
   ISSN = {1897-9483 (Print)},
   Accession Number = {19140565},
   year = {2008},
   type = {Ref–rence Type}
}

@article{
   author = {Faresjo, A. and Grodzinsky, E. and Johansson, S. and Wallander, M. A. and Timpka, T. and Akerlind, I.},
   title = {Psychosocial factors at work and in every day life are associated with irritable bowel syndrome},
   journal = {Eur J Epidemiol},
   volume = {22},
   number = {7},
   pages = {473-80},
   note = {Faresjo, Ashild
Grodzinsky, Ewa
Johansson, Saga
Wallander, Mari-Ann
Timpka, Toomas
Akerlind, Ingemar
Journal Article
Research Support, Non-U.S. Gov't
Netherlands
Eur J Epidemiol. 2007;22(7):473-80. Epub 2007 May 5.},
   abstract = {The etiology of irritable bowel syndrome (IBS) tends to be complex and multi-factorial and there is still a lack of understanding of how different psychosocial factors are associated with the syndrome. Our aim was to examine the occurrence of psychosocial and behavioural factors among patients diagnosed with IBS in primary care. The study had an epidemiological population-based case-control design comparing 347 IBS cases to 1041 age and sex matched controls from the general population. A survey was directed to cases and controls based on validated questions asking for mood status, job strain, family history of IBS, and sleeping habits as well as education, nutritional and exercise habits and medication. In multivariate analyses, independent associations were found between IBS and lack of influence on work planning, a family history of IBS, anxiety, and sleeping disturbances. Important factors associated with IBS diagnosis among females were anxiety as well as family history of IBS and lack of co-determination at work. For males, only lack of influence on working pace and family history of IBS remained independently associated with an IBS diagnosis. The causal associations of the complex risk factor panorama for IBS warrants further study. This study indicates that there should be a special focus on investigating the psychosocial working conditions and their associations to IBS.},
   keywords = {Adult
Analysis of Variance
Anxiety/physiopathology
Case-Control Studies
Educational Status
Family Characteristics
Female
Humans
Irritable Bowel Syndrome/epidemiology/physiopathology/*psychology
Job Satisfaction
Male
Middle Aged
Mood Disorders/physiopathology
Power (Psychology)
Primary Health Care/*utilization
Quality of Life/*psychology
Sex Factors
Social Control, Formal
Stress, Psychological/epidemiology/*physiopathology
Surveys and Questionnaires
Sweden/epidemiology
Work/*psychology},
   ISSN = {0393-2990 (Print)
0393-2990},
   Accession Number = {17484023},
   DOI = {10.1007/s10654-007-9133-2},
   year = {2007},
   type = {Ref–rence Type}
}

@article{
   author = {Ferrier, L.},
   title = {Significance of increased human colonic permeability in response to corticotrophin-releasing hormone (CRH)},
   journal = {Gut},
   volume = {57},
   number = {1},
   pages = {7-9},
   note = {1468-3288
Ferrier, Laurent
Comment
Journal Article
Research Support, Non-U.S. Gov't
England
Gut. 2008 Jan;57(1):7-9.},
   keywords = {Biopsy
Colon/pathology
Corticotropin-Releasing Hormone/*physiology
Female
Gastrointestinal Motility/*physiology
Humans
Inflammatory Bowel Diseases/physiopathology
Irritable Bowel Syndrome/physiopathology
Male
Permeability
Receptors, Corticotropin-Releasing Hormone},
   ISSN = {0017-5749},
   Accession Number = {18094198},
   DOI = {10.1136/gut.2007.129841},
   year = {2008},
   type = {Ref–rence Type}
}

@article{
   author = {Gawronska, A. and Dziechciarz, P. and Horvath, A. and Szajewska, H.},
   title = {A randomized double-blind placebo-controlled trial of Lactobacillus GG for abdominal pain disorders in children},
   journal = {Aliment Pharmacol Ther},
   volume = {25},
   number = {2},
   pages = {177-84},
   note = {Gawronska, A
Dziechciarz, P
Horvath, A
Szajewska, H
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
England
Aliment Pharmacol Ther. 2007 Jan 15;25(2):177-84.},
   abstract = {BACKGROUND: Functional abdominal pain disorders (FAPD) are common in school-aged children; however, there is no reliable treatment. AIM: To determine the efficacy of Lactobacillus rhamnosus GG (LGG) for treating FAPD in children. METHODS: A total of 104 children who fulfilled the Rome II criteria for functional dyspepsia (FD), or irritable bowel syndrome (IBS), or functional abdominal pain (FAP) were enrolled in a double-blind, randomized controlled trial in which they received LGG (n = 52), or placebo (n = 52) for 4 weeks. RESULTS: For the overall study population, those in the LGG group were more likely to have treatment success (no pain) than those in the placebo group (25% vs. 9.6%, relative benefit (RB) 2.6, 95% confidence interval (CI): 1.05-6.6, number needed to treat (NNT) 7, 95% CI: 4-123). For children with IBS (n = 37), those in the LGG group were more likely to have treatment success than those in the placebo group (33% vs. 5%, RB 6.3, 95% CI: 1.2-38, NNT 4, 95% CI: 2-36) and reduced frequency of pain (P = 0.02), but not pain severity (P = 0.10). For the FD group (n = 20) and FAP group (n = 47), no differences were found. CONCLUSION: The LGG appears to moderately increase treatment success, particularly among children with IBS.},
   keywords = {Abdominal Pain/*diet therapy
Adolescent
Child
Double-Blind Method
Dyspepsia/*diet therapy
Female
Humans
Irritable Bowel Syndrome/*diet therapy
*Lactobacillus rhamnosus
Male
Probiotics/*therapeutic use
Treatment Outcome},
   ISSN = {0269-2813 (Print)
0269-2813},
   Accession Number = {17229242},
   DOI = {10.1111/j.1365-2036.2006.03175.x},
   year = {2007},
   type = {Ref–rence Type}
}

@article{
   author = {Gecse, K. and Roka, R. and Ferrier, L. and Leveque, M. and Eutamene, H. and Cartier, C. and Ait-Belgnaoui, A. and Rosztoczy, A. and Izbeki, F. and Fioramonti, J. and Wittmann, T. and Bueno, L.},
   title = {Increased faecal serine protease activity in diarrhoeic IBS patients: a colonic lumenal factor impairing colonic permeability and sensitivity},
   journal = {Gut},
   volume = {57},
   number = {5},
   pages = {591-9},
   note = {1468-3288
Gecse, K
Roka, R
Ferrier, L
Leveque, M
Eutamene, H
Cartier, C
Ait-Belgnaoui, A
Rosztoczy, A
Izbeki, F
Fioramonti, J
Wittmann, T
Bueno, L
Journal Article
Research Support, Non-U.S. Gov't
England
Gut. 2008 May;57(5):591-9. doi: 10.1136/gut.2007.140210. Epub 2008 Jan 14.},
   abstract = {OBJECTIVES: Diarrhoea-predominant irritable bowel syndrome (IBS-D) is characterised by elevated colonic lumenal serine protease activity. The aims of this study were (1) to investigate the origin of this elevated serine protease activity, (2) to evaluate if it may be sufficient to trigger alterations in colonic paracellular permeability (CPP) and sensitivity, and (3) to examine the role of the proteinase-activated receptor-2 (PAR-2) activation and signalling cascade in this process. PATIENTS AND METHODS: Faecal enzymatic activities were assayed in healthy subjects and patients with IBS, ulcerative colitis and acute infectious diarrhoea. Following mucosal exposure to supernatants from control subjects and IBS-D patients, electromyographic response to colorectal balloon distension was recorded in wild-type and PAR-2(-/-) mice, and CPP was evaluated on colonic strips in Ussing chambers. Zonula occludens-1 (ZO-1) and phosphorylated myosin light chain were detected by immunohistochemistry. RESULTS: The threefold increase in faecal serine protease activity seen in IBS-D patients compared with constipation-predominant IBS (IBS-C) or infectious diarrhoea is of neither epithelial nor inflammatory cell origin, nor is it coupled with antiprotease activity of endogenous origin. Mucosal application of faecal supernatants from IBS-D patients in mice evoked allodynia and increased CPP by 92%, both of which effects were prevented by serine protease inhibitors and dependent on PAR-2 expression. In mice, colonic exposure to supernatants from IBS-D patients resulted in a rapid increase in the phosphorylation of myosin light chain and delayed redistribution of ZO-1 in colonocytes. CONCLUSIONS: Elevated colonic lumenal serine protease activity of IBS-D patients evokes a PAR-2-mediated colonic epithelial barrier dysfunction and subsequent allodynia in mice, suggesting a novel organic background in the pathogenesis of IBS.},
   keywords = {Adult
Aged
Aged, 80 and over
Animals
Biomarkers/metabolism
Colon/*enzymology
Diarrhea/*enzymology
Feces/*enzymology
Female
Humans
Intestinal Mucosa/enzymology
Irritable Bowel Syndrome/diagnosis/*enzymology
Male
Mice
Mice, Inbred C57BL
Middle Aged
Permeability
Receptor, PAR-2/metabolism
Serine Endopeptidases/*metabolism},
   ISSN = {0017-5749},
   Accession Number = {18194983},
   DOI = {10.1136/gut.2007.140210},
   year = {2008},
   type = {Ref–rence Type}
}

@article{
   author = {Grand, R. J. and Montgomery, R. K.},
   title = {Lactose malabsorption},
   journal = {Curr Treat Options Gastroenterol},
   volume = {11},
   number = {1},
   pages = {19-25},
   note = {Grand, Richard J
Montgomery, Robert K
Journal Article
United States
Curr Treat Options Gastroenterol. 2008 Feb;11(1):19-25. doi: 10.1007/s11938-008-0003-0.},
   abstract = {OPINION STATEMENT: Lactose malabsorption is a syndrome producing constellation of symptoms, including abdominal pain, bloating, flatulence, diarrhea, and sometimes nausea and/or vomiting. Primary causes of lactose malabsorption due to loss of intestinal lactase activity include genetic/racial lactase nonpersistence, congenital lactase deficiency, and developmental lactase deficiency. Secondary lactose malabsorption can be caused by any disorder that injures the small intestinal mucosa, such as viral gastroenteritis, celiac disease, allergic (eosinophilic) gastroenteritis, and radiation enteritis. The diagnosis depends on careful clinical evaluation and is customarily confirmed with a lactose breath hydrogen test. As the symptoms are nonspecific, many adults diagnosed with lactose malabsorption actually have irritable bowel syndrome. Treatment consists of a trial of eliminating lactose-containing dairy foods, with supplementation of alternative calcium and protein sources. Commercial enzyme products containing beta-galactosidases can be prescribed to help patients digest dietary lactose. Long-term lactose restriction usually is not necessary and can lead to reduced bone mineral density.},
   ISSN = {1092-8472 (Print)
1092-8472},
   Accession Number = {21063860},
   DOI = {10.1007/s11938-008-0003-0},
   year = {2008},
   type = {Ref–rence Type}
}

@article{
   author = {Grundy, D.},
   title = {5-HT system in the gut: roles in the regulation of visceral sensitivity and motor functions},
   journal = {Eur Rev Med Pharmacol Sci},
   volume = {12 Suppl 1},
   pages = {63-7},
   note = {Grundy, D
Journal Article
Review
Italy
Eur Rev Med Pharmacol Sci. 2008 Aug;12 Suppl 1:63-7.},
   abstract = {5-Hydroxytryptamine (5-HT) is a major transmitter molecule within the gastrointestinal tract. It is contained in enterochromaffin (EC) cells, which form part of the epithelial lining of the gut and in enteric neurones in the submucosal and myenteric plexuses. 5-HT is present in murine mucosal mast cells in the lamina propria and some studies have suggested that human mast cells may also contain 5-HT especially in conditions associated with mastocytosis. The strategic positioning of the enteric and extrinsic sensory innervation in close proximity to these sources of 5-HT, in conjunction with their demonstrated sensitivity to this mediator, suggests the involvement of 5-HT in the transduction of visceral stimuli and reflex responses affecting motor and secretory function. Under physiological conditions, the release of 5-HT from these storage sites may result in the orchestration of reflexes responsible for transit of material along the bowel at a rate that is appropriate for digestion and absorption of nutrients. However, in the pathophysiological state, 5-HT acting together with other inflammatory mediators may cause inappropriate intestinal secretomotor activity and/or initiate sensations such as nausea or discomfort/pain. Current evidence suggests that the bioavailability of 5-HT within the gut wall is altered in a number of post-inflammatory models of gut dysfunction with increased numbers of EC cells and mast cells with increased 5-HT content in proximity to sensory nerve endings, and decreased serotonin reuptake mechanisms. Changes may also occur in the sensory innervation or pathways within the central nervous system. These processes may contribute to pain mechanisms in the irritable bowel syndrome, in which visceral hypersensitivity is a predominant feature and may also contribute to motor dysfunction leading to altered bowel habit.},
   keywords = {Animals
Digestive System/*innervation
Enterochromaffin Cells/physiology
Humans
Irritable Bowel Syndrome/drug therapy/physiopathology
Motor Neurons/*physiology
Neurons, Afferent/physiology
Receptors, Serotonin/biosynthesis
Serotonin/*physiology
Vomiting/physiopathology},
   ISSN = {1128-3602 (Print)
1128-3602},
   Accession Number = {18924445},
   year = {2008},
   type = {Ref–rence Type}
}

@article{
   author = {Hamblin, L. and Laird, A. and Parkes, E. and Walker, A. F.},
   title = {Improved arthritic knee health in a pilot RCT of phytotherapy},
   journal = {J R Soc Promot Health},
   volume = {128},
   number = {5},
   pages = {255-62},
   note = {Hamblin, Louise
Laird, Alex
Parkes, Edward
Walker, Ann F
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
England
J R Soc Promot Health. 2008 Sep;128(5):255-62.},
   abstract = {Although practitioner-prescribed 'western' herbal medicine (phytotherapy) is a popular complementary therapy in the UK, no clinical studies have been reported on patient-orientated outcomes. The objective of this pilot study was to investigate the effects of phytotherapy on symptoms of osteoarthritis of the knee. A previous study of Chinese herbal medicine for the treatment of irritable bowel syndrome, published in the Journal of the American Medical Association, acted as a model in the development of the protocol of this investigation. Twenty adults, previously diagnosed with osteoarthritis of the knee, were recruited from two Inner London GP practices into this randomized, double-blind, placebo-controlled, pilot study carried out in a primary-care setting. All subjects were seen in consultation three times by a herbal practitioner who was blinded to the randomization coding. Each subject was prescribed treatment and given lifestyle advice according to usual practice: continuation of conventional medication where applicable, healthy-eating advice and nutrient supplementation. Individualized herbal medicine was prescribed for each patient, but only dispensed for those randomized to active treatment-- the remainder were supplied with a placebo. At baseline and outcome (after ten weeks of treatment), subjects completed a food frequency questionnaire and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) knee health and Measure Yourself Outcome Profile (MYMOP) wellbeing questionnaires. Subjects completing the study per protocol (n = 14) reported an increased intake of wholegrain foods (p = 0.045) and oily fish (p = 0.039) compared to baseline, but no increase in fruit and vegetables and dairy products intakes. There was no difference in the primary outcome measure of knee health assessed as the difference in the mean response (baseline-week 10) in WOMAC score between the two treatment groups. However, there was, compared with baseline, improvement in the active group (n = 9) for the mean WOMAC stiffness sub-score at week 5 (p = 0.035) and week 10 (p = 0.060) but not in the placebo group (n = 5). Furthermore, for the active, but not the placebo group, the mean WOMAC total and sub-scores all showed clinically significant improvement (> or = 20%) in knee symptoms at weeks 5 and 10 compared with baseline. Moreover, the mean MYMOP symptom 2 sub-score, mostly relating to osteoarthritis (OA), showed significant improvement at week 5 (p = 0.02) and week 10 (p = 0.008) compared with baseline for the active, but not for the placebo group. This pilot study showed that herbal medicine prescribed for the individual by a herbal practitioner resulted in improvement of symptoms of OA of the knee.},
   keywords = {Aged
Diet
Double-Blind Method
Female
Humans
Male
Motor Activity
Osteoarthritis, Knee/*drug therapy
Pain
*Phytotherapy
Pilot Projects},
   ISSN = {1466-4240 (Print)
1466-4240},
   Accession Number = {18814408},
   year = {2008},
   type = {Ref–rence Type}
}

@article{
   author = {Hanauer, S. B.},
   title = {The benefits of loperamide in the treatment of patients with IBS or IBD. Introduction},
   journal = {Rev Gastroenterol Disord},
   volume = {7 Suppl 3},
   pages = {S1-2},
   note = {Hanauer, Stephen B
Introductory Journal Article
United States
Rev Gastroenterol Disord. 2007;7 Suppl 3:S1-2.},
   keywords = {Antidiarrheals/*therapeutic use
Humans
Inflammatory Bowel Diseases/*drug therapy
Irritable Bowel Syndrome/*drug therapy
Loperamide/*therapeutic use},
   ISSN = {1533-001X (Print)
1533-001x},
   Accession Number = {18192960},
   year = {2007},
   type = {Ref–rence Type}
}

@article{
   author = {Hanauer, S. B.},
   title = {The role of loperamide in gastrointestinal disorders},
   journal = {Rev Gastroenterol Disord},
   volume = {8},
   number = {1},
   pages = {15-20},
   note = {Hanauer, Stephen B
Journal Article
Review
United States
Rev Gastroenterol Disord. 2008 Winter;8(1):15-20.},
   abstract = {Loperamide is an effective therapy for a variety of diarrheal syndromes, including acute, nonspecific (infectious) diarrhea; traveler's diarrhea; and chemotherapy-related and protease inhibitor?associated diarrhea. Loperamide is effective for the "gut-directed" symptom of diarrhea in patients with painless diarrhea or diarrhea-predominant irritable bowel syndrome. Loperamide and diphenoxylate are commonly used to treat diarrhea in numerous settings of inflammatory bowel disease. Loperamide has also been observed to increase anal sphincter tone, which may lead to improvement of fecal continence in patients with and without diarrhea. Loperamide is generally well tolerated at recommended nonprescription doses, with the most common side effects related to the impact on bowel motility (abdominal pain, distention, bloating, nausea, vomiting, and constipation).},
   keywords = {Antidiarrheals/pharmacology/*therapeutic use
Diarrhea/*drug therapy/etiology
Fecal Incontinence/drug therapy
Humans
Irritable Bowel Syndrome/*drug therapy
Loperamide/pharmacology/*therapeutic use},
   ISSN = {1533-001X (Print)
1533-001x},
   Accession Number = {18477966},
   year = {2008},
   type = {Ref–rence Type}
}

@article{
   author = {Heitkemper, M. M. and Jarrett, M. E.},
   title = {Update on irritable bowel syndrome and gender differences},
   journal = {Nutr Clin Pract},
   volume = {23},
   number = {3},
   pages = {275-83},
   note = {Heitkemper, Margaret M
Jarrett, Monica E
NR01094/NR/NINR NIH HHS/United States
P30 NR04001/NR/NINR NIH HHS/United States
Journal Article
Research Support, N.I.H., Extramural
Review
United States
Nutr Clin Pract. 2008 Jun-Jul;23(3):275-83. doi: 10.1177/0884533608318672.},
   abstract = {Irritable bowel syndrome (IBS) is a chronic functional GI disorder characterized by abdominal pain associated with alterations in defecation or stool frequency and consistency. In Western industrialized countries, women seek health care services for their symptoms more frequently than men. The cause of IBS is likely multifactorial involving altered motility, visceral hypersensitivity, and dysregulation of the autonomic nervous system. Many patients note that their symptoms are exacerbated by diet and stress, and women frequently report menstrual cycle fluctuations in symptoms. Current approaches to IBS management include behavioral management therapies such as dietary intake changes and stress reduction cognitive restructuring. Drug therapies are targeted at altering pain sensitivity, motility, and secretion. This review provides an overview of the pathogenesis of IBS, factors that contribute to gender differences, and current therapeutic approaches for symptom management.},
   keywords = {Abdominal Pain/diagnosis/etiology
Autonomic Nervous System/*physiopathology
*Diet/adverse effects
Female
Gastrointestinal Motility
Humans
Irritable Bowel Syndrome/epidemiology/*etiology/*psychology/therapy
Male
Menstrual Cycle/physiology
Probiotics/therapeutic use
Serotonin/physiology
Sex Factors
Stress, Psychological/*complications},
   ISSN = {0884-5336 (Print)
0884-5336},
   Accession Number = {18595860},
   DOI = {10.1177/0884533608318672},
   year = {2008},
   type = {Ref–rence Type}
}

@article{
   author = {Hyams, J. S.},
   title = {Organization of a research consortium: the time is now},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {47},
   number = {5},
   pages = {713-5},
   note = {1536-4801
Hyams, Jeffrey S
Journal Article
United States
J Pediatr Gastroenterol Nutr. 2008 Nov;47(5):713-5. doi: 10.1097/01.mpg.0000338971.57088.c0.},
   keywords = {Abdominal Pain/diagnosis/*therapy
Child
Consensus Development Conferences as Topic
Humans
Irritable Bowel Syndrome/diagnosis/therapy
Research/*organization & administration},
   ISSN = {0277-2116},
   Accession Number = {18955889},
   DOI = {10.1097/01.mpg.0000338971.57088.c0},
   year = {2008},
   type = {Ref–rence Type}
}

@article{
   author = {Kerber, M. and Oberkanins, C. and Kriegshauser, G. and Kollerits, B. and Dossenbach-Glaninger, A. and Fuchs, D. and Ledochowski, M.},
   title = {Hydrogen breath testing versus LCT genotyping for the diagnosis of lactose intolerance: a matter of age?},
   journal = {Clin Chim Acta},
   volume = {383},
   number = {1-2},
   pages = {91-6},
   note = {Kerber, Michaela
Oberkanins, Christian
Kriegshauser, Gernot
Kollerits, Barbara
Dossenbach-Glaninger, Astrid
Fuchs, Dietmar
Ledochowski, Maximilian
Comparative Study
Evaluation Studies
Journal Article
Research Support, Non-U.S. Gov't
Netherlands
Clin Chim Acta. 2007 Aug;383(1-2):91-6. Epub 2007 May 10.},
   abstract = {BACKGROUND: Two single nucleotide polymorphisms (-13910 C/T and -22018 G/A) upstream of the lactase gene (LCT) have been found to be associated with lactose tolerance in Europeans. METHODS: In one hundred and twenty Austrian outpatients, who visited the physician's office for symptoms of irritable bowel syndrome (IBS), hydrogen breath testing (HBT) and LCT genotyping by polymerase chain reaction and reverse-hybridisation were performed in parallel. RESULTS: The coincidence between a genotype suggesting lactase non-persistence (lactose intolerance) and a positive HBT result was almost perfect (97.4% for LCT-13910 C/T and 100% for LCT-22018 G/A). Between a genotype indicating lactase persistence (lactose tolerance) and a negative HBT result the coincidence was lower (72% and 71.4%, respectively). Among heterozygotes, there was a statistically significant increase in the proportion of positive HBT results with age. Both SNPs were in accordance in 117/120 (97.5%) patients. CONCLUSION: Genetic analysis of LCT-13910 C/T and LCT-22018 G/A is a good indicator for the presence of lactose intolerance. Because age, as well as a number of secondary causes (e.g. celiac disease), can influence HBT results, it is useful to combine HBT and genetic analysis in the diagnostic assessment of IBS.},
   keywords = {Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Austria
Breath Tests/*methods
Child
Diagnostic Errors
Female
Genetic Testing/methods/*standards
Genotype
Humans
Hydrogen/*analysis
Lactase/*genetics
Lactose Intolerance/*diagnosis
Male
Middle Aged
Polymorphism, Single Nucleotide
Reproducibility of Results},
   ISSN = {0009-8981 (Print)
0009-8981},
   Accession Number = {17574225},
   DOI = {10.1016/j.cca.2007.04.028},
   year = {2007},
   type = {Ref–rence Type}
}

@article{
   author = {Khan, S. and Campo, J. and Bridge, J. A. and Chiappetta, L. C. and Wald, A. and di Lorenzo, C.},
   title = {Long-term outcome of functional childhood constipation},
   journal = {Dig Dis Sci},
   volume = {52},
   number = {1},
   pages = {64-9},
   note = {Khan, Seema
Campo, John
Bridge, Jeffrey A
Chiappetta, Laurel C
Wald, Arnold
di Lorenzo, Carlo
Journal Article
United States
Dig Dis Sci. 2007 Jan;52(1):64-9. Epub 2006 Dec 7.},
   abstract = {We investigated whether functional childhood constipation (FCC) is an early expression in the continuum of functional disorders such as adult constipation, irritable bowel syndrome (IBS), and dyspepsia. Adults >or=18 years with a diagnosis of FCC verified by one pediatric gastroenterologist participated in the questionnaire-based study. Controls were comprised of adults who underwent tonsillectomy as otherwise healthy children during the period corresponding to the FCC diagnosis. The prevalence of constipation, IBS, and dyspepsia was determined by the Bowel Disease Questionnaire. Twenty FCC adults (8 females), median age 22 years, were compared with 17 adult controls (10 females), median age 22.9 years. The frequency of constipation in FCC adults was not different from that in controls (25% versus 23.5%). The frequency of IBS in FCC adults was higher than in controls (55% versus 23.5%; P < 0.05). Dyspepsia was reported by 25% of both groups. The median follow-up period of the FCC adults was 14 years. In a long-term follow-up of a small sample, the prevalence of constipation in FCC adults is comparable to that in controls. Childhood constipation appears to be a predictor of IBS in adulthood.},
   keywords = {Adolescent
Animals
Child
Child, Preschool
Colonic Diseases, Functional/complications/epidemiology
Constipation/*epidemiology
Health Status Indicators
Humans
Irritable Bowel Syndrome/epidemiology
Male
Prevalence
Quality of Life
Retrospective Studies},
   ISSN = {0163-2116 (Print)
0163-2116},
   Accession Number = {17151806},
   DOI = {10.1007/s10620-006-9308-9},
   year = {2007},
   type = {Ref–rence Type}
}

@article{
   author = {Knowles, C. H.},
   title = {New horizons in the pathogenesis of gastrointestinal neuromuscular disease},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {45 Suppl 2},
   pages = {S97-102},
   note = {1536-4801
Knowles, Charles H
Journal Article
Review
United States
J Pediatr Gastroenterol Nutr. 2007 Dec;45 Suppl 2:S97-102. doi: 10.1097/MPG.0b013e31812e6569.},
   abstract = {The term "gastrointestinal neuromuscular disease" can be interpreted variably and encompasses a spectrum of paediatric and adult conditions including achalasia, pseudoobstruction, idiopathic constipation, irritable bowel syndrome, megacolon, and Hirschsprung disease. Although progress has been made in the understanding of the pathophysiology of some conditions, the aetiopathogenesis has been elucidated only in the rare minority. This review critically considers the available evidence for possible pathogenic mechanisms in these disorders.},
   keywords = {Aging/pathology
Biomarkers
Evidence-Based Medicine
Gastrointestinal Diseases/etiology/*pathology
Gastrointestinal Motility/*physiology
Humans
Neuromuscular Diseases/etiology/*pathology},
   ISSN = {0277-2116},
   Accession Number = {18185077},
   DOI = {10.1097/MPG.0b013e31812e6569},
   year = {2007},
   type = {Ref–rence Type}
}

@article{
   author = {Kussmann, M. and Blum, S.},
   title = {OMICS-derived targets for inflammatory gut disorders: opportunities for the development of nutrition related biomarkers},
   journal = {Endocr Metab Immune Disord Drug Targets},
   volume = {7},
   number = {4},
   pages = {271-87},
   note = {Kussmann, M
Blum, S
Journal Article
Review
United Arab Emirates
Endocr Metab Immune Disord Drug Targets. 2007 Dec;7(4):271-87.},
   abstract = {Modern molecular nutrition focuses on health promotion, disease prevention and performance improvement through diet. In analogy to Pharmacogenetics and -genomics, the disciplines "Nutrigenetics" and "Nutrigenomics" have evolved. Nutrigenetics asks how individual genetic disposition, manifesting as single-nucleotide- and copy-number polymorphisms as well as epigenetic regulation, affects susceptibility to diet. Nutrigenomics addresses the inverse relationship, i.e. how diet influences gene transcription, protein expression and metabolism. The long-term objective of Nutrigenomics is personalised nutrition for maintenance and improvement of individual health and for disease prevention. Transcriptomics can put Proteomics- and Metabonomics-derived markers into a larger biological perspective. Metabonomics is a diagnostic tool for metabolic classification of individuals with the asset of quantitative, non-invasive analysis of easily accessible human body fluids such as urine, blood and saliva. This feature also applies to some extent to Proteomics, with the constraint that the latter discipline is more complex in terms of composition and dynamic range of the sample. Apart from addressing the most complex "Ome", Proteomics represents the only platform that delivers not only markers for disposition and efficacy but also targets of intervention. Application of integrated Omic technologies will drive the understanding of interrelated pathways in healthy and pathological conditions and will help to define molecular 'switchboards', necessary to develop disease related biomarkers. This will contribute to the development of new preventive and therapeutic strategies for both pharmacological and nutritional interventions. This paper reviews inflammatory gut disorders, the state-of-the-art of the three Omics platforms and discusses the implication of the latter in biomarker revelation for nutritionally actionable inflammatory disorders in the intestine.},
   keywords = {Animals
Biomarkers/analysis/metabolism
Gene Expression Profiling/methods
Humans
Inflammatory Bowel Diseases/genetics/*metabolism
Intestines/metabolism
Irritable Bowel Syndrome/genetics/*metabolism
Metabolism/genetics
Nutrigenomics/*methods
Proteomics/methods},
   ISSN = {1871-5303 (Print)
1871-5303},
   Accession Number = {18220948},
   year = {2007},
   type = {Ref–rence Type}
}

@article{
   author = {Lebel, A. A.},
   title = {Pharmacology},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {47},
   number = {5},
   pages = {703-5},
   note = {1536-4801
Lebel, Alyssa A
Journal Article
United States
J Pediatr Gastroenterol Nutr. 2008 Nov;47(5):703-5. doi: 10.1097/01.mpg.0000338966.70550.d1.},
   keywords = {Afferent Pathways/drug effects/physiopathology
Analgesics/therapeutic use
Anticonvulsants/therapeutic use
Antidepressive Agents/therapeutic use
Child
Gastrointestinal Diseases/*drug therapy/psychology
Humans
Hypnotics and Sedatives/therapeutic use
Irritable Bowel Syndrome/*drug therapy/psychology
Pain},
   ISSN = {0277-2116},
   Accession Number = {18955884},
   DOI = {10.1097/01.mpg.0000338966.70550.d1},
   year = {2008},
   type = {Ref–rence Type}
}

@article{
   author = {Lomax, A. R. and Calder, P. C.},
   title = {Prebiotics, immune function, infection and inflammation: a review of the evidence},
   journal = {Br J Nutr},
   volume = {101},
   number = {5},
   pages = {633-58},
   note = {1475-2662
Lomax, Amy R
Calder, Philip C
Journal Article
Review
England
Br J Nutr. 2009 Mar;101(5):633-58. doi: 10.1017/S0007114508055608. Epub 2008 Sep 25.},
   abstract = {Beta2-1 fructans are carbohydrate molecules with prebiotic properties. Through resistance to digestion in the upper gastrointestinal tract, they reach the colon intact, where they selectively stimulate the growth and/or activity of beneficial members of the gut microbiota. Through this modification of the intestinal microbiota, and by additional mechanisms, beta2-1 fructans may have beneficial effects upon immune function, ability to combat infection, and inflammatory processes and conditions. In this paper, we have collated, summarised and evaluated studies investigating these areas. Twenty-one studies in laboratory animals suggest that some aspects of innate and adaptive immunity of the gut and the systemic immune systems are modified by beta2-1 fructans. In man, two studies in children and nine studies in adults indicate that the adaptive immune system may be modified by beta2-1 fructans. Thirteen studies in animal models of intestinal infections conclude a beneficial effect of beta2-1 fructans. Ten trials involving infants and children have mostly reported benefits on infectious outcomes; in fifteen adult trials, little effect was generally seen, although in specific situations, certain beta2-1 fructans may be beneficial. Ten studies in animal models show benefit of beta2-1 fructans with regard to intestinal inflammation. Human studies report some benefits regarding inflammatory bowel disease (four positive studies) and atopic dermatitis (one positive study), but findings in irritable bowel syndrome are inconsistent. Therefore, overall the results indicate that beta2-1 fructans are able to modulate some aspects of immune function, to improve the host's ability to respond successfully to certain intestinal infections, and to modify some inflammatory conditions.},
   keywords = {Adult
Aged
Animals
Child
Child, Preschool
Disease Models, Animal
Evidence-Based Medicine
Female
Fructans/immunology/*therapeutic use
Humans
Immune System/*drug effects
Infant
Infant, Newborn
Inflammation/immunology/*therapy
Intestines/immunology/microbiology
Lymphoid Tissue/immunology
Male
Middle Aged
Opportunistic Infections/immunology/*prevention & control
*Prebiotics
Young Adult},
   ISSN = {0007-1145},
   Accession Number = {18814803},
   DOI = {10.1017/s0007114508055608},
   year = {2009},
   type = {Ref–rence Type}
}

@article{
   author = {Lombardo, L.},
   title = {New insights into Lactobacillus and functional intestinal disorders},
   journal = {Minerva Gastroenterol Dietol},
   volume = {54},
   number = {3},
   pages = {287-93},
   note = {Lombardo, L
Journal Article
Review
Italy
Minerva Gastroenterol Dietol. 2008 Sep;54(3):287-93.},
   abstract = {Intestinal microflora can be considered as a ''dynamic system'' that actively interacts with the intestinal epithelium and the local immune system. It synthesizes antimicrobial substances (bacteriocins), vitamins (PP, B1, B6, B12), it produces a major intestinal nutrient (butyric acid) and interacts in a competitive fashion with the pathogens. Lactobacilli concentration (Gram+, Gram variable, facultative anaerobes) is generally decreased in irritable bowel syndrome (IBS) patients. This syndrome has, until recently been considered to be ''functional'', whereas, in fact, it may result from previous enteritis (in up to 31% of patients), featuring a persistent low-grade intestinal inflammation and a reduction in interleukin-10 (IL-10) concentration. Some Lactobacilli strains (e.g. L. paracasei subsp. paracasei) in vitro lead to normalisation of the hypercontractility of the smooth muscle cells. A growing body of clinical findings indicates that some ''genetically stable'' strains of Lactobacilli may be useful in the treatment, even long term, of IBS, and reduce the postoperative infection rate, especially in critically ill patients (orthotopic liver transplant, severe pancreatitis). However, some Lactobacilli, ''not genetically stable'', used in the treatment of neutropenic patients during chemotherapy and in pediatric patients submitted to gastrojejunostomy, have been reported to lead to bacteremia and endocarditis. These effects may be due to transfer of bacteria and genetic material. Therefore, the confirmed genetic stability and the fact that no antibiotic resistance occurs are fundamental requisites for the use of Lactobacilli in certain disorders of the gastrointestinal tract, such as, for instance, IBS. In conclusion, ''genetically stable'' Lactobacilli (L. paracasei subsp. Paracasei F19) have recently become available, representing an exiting new field in clinical studies and for treatment purposes, offering guarantees of safety also for long-term use. Careful personalized evaluation, as always in medical practice, is necessary in order to gain further insight into, and to validate with additional studies, the role of ''genetically stable'' Lactobacilli in the treatment of IBS.},
   keywords = {Anti-Bacterial Agents/therapeutic use
Bacteriocins/therapeutic use
Butyric Acid/therapeutic use
Evidence-Based Medicine
Gastrointestinal Motility/drug effects
Humans
Irritable Bowel Syndrome/physiopathology/*therapy
*Lactobacillus
Probiotics/*therapeutic use
Quality of Life
Randomized Controlled Trials as Topic
Treatment Outcome
Vitamins/therapeutic use},
   ISSN = {1121-421X (Print)
1121-421x},
   Accession Number = {18614977},
   year = {2008},
   type = {Ref–rence Type}
}

@article{
   author = {McOmber, M. A. and Shulman, R. J.},
   title = {Pediatric functional gastrointestinal disorders},
   journal = {Nutr Clin Pract},
   volume = {23},
   number = {3},
   pages = {268-74},
   note = {McOmber, Mark A
Shulman, Robert J
T32-DK07664/DK/NIDDK NIH HHS/United States
R01 NR005337-01A2/NR/NINR NIH HHS/United States
P30-DK56338/DK/NIDDK NIH HHS/United States
R01 NR005337/NR/NINR NIH HHS/United States
R01-NR05337/NR/NINR NIH HHS/United States
P30 DK056338/DK/NIDDK NIH HHS/United States
P30 DK056338-01A1/DK/NIDDK NIH HHS/United States
T32 DK007664-17/DK/NIDDK NIH HHS/United States
T32 DK007664/DK/NIDDK NIH HHS/United States
Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.
Review
United States
Nutr Clin Pract. 2008 Jun-Jul;23(3):268-74. doi: 10.1177/0884533608318671.},
   abstract = {Functional gastrointestinal disorders continue to be a prevalent set of conditions faced by the healthcare team and have a significant emotional and economic impact. In this review, the authors highlight some of the common functional disorders seen in pediatric patients (functional dyspepsia, irritable bowel syndrome, functional abdominal pain) as well as one of the more intriguing (cyclic vomiting). The most recent Pediatric Rome Working Group has modified the definitions of functional gastrointestinal disorders. Current studies have used these categorizations to understand better the epidemiology, etiology, and treatment options for these disorders. As more data are available, children and their families will be offered a better understanding of the conditions and more effective treatments to overcome them. The importance of making an accurate diagnosis of a functional gastrointestinal disorder cannot be overemphasized.},
   keywords = {Abdominal Pain/diagnosis/etiology
Child
Dyspepsia/*diagnosis/epidemiology/pathology
Gastrointestinal Diseases/*diagnosis/epidemiology/pathology
Humans
Irritable Bowel Syndrome/*diagnosis/epidemiology/pathology
Recurrence
Severity of Illness Index
Vomiting/*diagnosis/epidemiology/pathology},
   ISSN = {0884-5336 (Print)
0884-5336},
   Accession Number = {18595859},
   DOI = {10.1177/0884533608318671},
   year = {2008},
   type = {Ref–rence Type}
}

@article{
   author = {McOmber, M. E. and Shulman, R. J.},
   title = {Recurrent abdominal pain and irritable bowel syndrome in children},
   journal = {Curr Opin Pediatr},
   volume = {19},
   number = {5},
   pages = {581-5},
   note = {McOmber, Mark E
Shulman, Robert J
T32 DK007664-18/DK/NIDDK NIH HHS/United States
DK 56338/DK/NIDDK NIH HHS/United States
R01 NR 05337/NR/NINR NIH HHS/United States
R01 NR005337-01A2/NR/NINR NIH HHS/United States
R01 NR005337/NR/NINR NIH HHS/United States
P30 DK056338/DK/NIDDK NIH HHS/United States
P30 DK056338-01A1/DK/NIDDK NIH HHS/United States
R01 NR005337-05/NR/NINR NIH HHS/United States
P30 DK056338-04/DK/NIDDK NIH HHS/United States
T32 DK007664-17/DK/NIDDK NIH HHS/United States
T32 DK007664/DK/NIDDK NIH HHS/United States
Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.
Review
United States
Curr Opin Pediatr. 2007 Oct;19(5):581-5.},
   abstract = {PURPOSE OF REVIEW: Recurrent abdominal pain continues to be one of the most ubiquitous conditions faced by the healthcare team, and has a significant emotional and economic impact. We have moved from considering it a psychological condition to recognizing the physiological and environmental contributions, and considering the condition in the framework of a biopsychosocial model where biology, psychology and social environment interact. Here, we review current studies addressing etiologies, diagnostic techniques and treatment options for recurrent abdominal pain in children. RECENT FINDINGS: Studies continue to highlight the role of visceral hypersensitivity in recurrent abdominal pain. The psychological state of the child and the parent (most often the mother) in terms of their anxiety, somatization and coping skills can, however, modulate the expression of symptoms. Diagnosis still is made by history and physical examination. Newer treatment options include relaxation and distraction therapies as well as medications. The role of probiotics in children remains to be defined. SUMMARY: The approach to the child with recurrent abdominal pain must include the recognition of the physiological contributions, and this information must be relayed to the child and parents. Acknowledgement also must be paid to the role of psychological state in the parent as well as in the child in modulating the severity of symptoms.},
   keywords = {*Abdominal Pain/diagnosis/psychology/therapy
Child
Humans
*Irritable Bowel Syndrome/diagnosis/psychology/therapy
Mothers/psychology
Recurrence},
   ISSN = {1040-8703 (Print)
1040-8703},
   Accession Number = {17885479},
   DOI = {10.1097/MOP.0b013e3282bf6ddc},
   year = {2007},
   type = {Ref–rence Type}
}

@article{
   author = {Miranda, A.},
   title = {Early life events and the development of visceral hyperalgesia},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {47},
   number = {5},
   pages = {682-4},
   note = {1536-4801
Miranda, Adrian
Journal Article
United States
J Pediatr Gastroenterol Nutr. 2008 Nov;47(5):682-4. doi: 10.1097/01.mpg.0000338958.94313.99.},
   keywords = {Child
Humans
Hyperalgesia/physiopathology/*psychology
Hypothalamo-Hypophyseal System/physiology
Irritable Bowel Syndrome/genetics/physiopathology
*Life Change Events
Neurons/physiology
Nociceptors/physiology
Pain/etiology
Pituitary-Adrenal System/physiology
Sensory Receptor Cells/physiology
Synaptic Transmission/physiology},
   ISSN = {0277-2116},
   Accession Number = {18955876},
   DOI = {10.1097/01.mpg.0000338958.94313.99},
   year = {2008},
   type = {Ref–rence Type}
}

@article{
   author = {Morken, M. H. and Berstad, A. E. and Nysaeter, G. and Berstad, A.},
   title = {Intestinal gas in plain abdominal radiographs does not correlate with symptoms after lactulose challenge},
   journal = {Eur J Gastroenterol Hepatol},
   volume = {19},
   number = {7},
   pages = {589-93},
   note = {Morken, Mette Helvik
Berstad, Audun Elnaes
Nysaeter, Gunnar
Berstad, Arnold
Journal Article
England
Eur J Gastroenterol Hepatol. 2007 Jul;19(7):589-93.},
   abstract = {OBSERVATION: Intestinal gas production and abdominal discomfort can be triggered by the ingestion of carbohydrates such as lactulose. Using plain abdominal radiographs, we studied whether subjective complaints after a lactulose breath test would be quantitatively related to intestinal gas volumes. METHODS: Abdominal symptoms after the breath test were quantified by a written questionnaire and gas volumes were scored in plain abdominal radiographs, in 50 consecutive patients with unexplained, irritable bowel syndrome-like symptoms. Breath excretion of hydrogen and methane was determined in all patients. RESULTS: Forty-two (84%) of the patients claimed that their post-breath test symptoms were a true replicate of their customary discomfort. Total symptom scores (sum of scores for pain/discomfort, borborygmi, bloating, diarrhea, constipation) or any specific symptom score were not significantly correlated to gas volume scores (r=-0.04; P=0.8 for total symptom score). The 13 (26%) methane producers had significantly higher mean gas volume scores compared with nonproducers (0.38 vs. 0.24; P=0.0008), but fewer symptoms (total symptom score 11.9 vs. 18.2; P=0.17). CONCLUSION: Intestinal gas volume, as scored in plain abdominal radiographs, is not correlated with abdominal discomfort after lactulose challenge. Intestinal gas may not be the major cause of abdominal discomfort following carbohydrate ingestion in patients with functional gut disorders.},
   keywords = {Adolescent
Adult
Aged
Aged, 80 and over
Breath Tests/methods
Female
Fermentation
Flatulence/diagnostic imaging/etiology/*physiopathology
Gases/*analysis
Humans
Hydrogen/metabolism
Intestines/diagnostic imaging/physiopathology
Irritable Bowel Syndrome/diagnostic imaging/*physiopathology
*Lactulose
Male
Methane/biosynthesis
Middle Aged
Radiography
Severity of Illness Index},
   ISSN = {0954-691X (Print)
0954-691x},
   Accession Number = {17556907},
   DOI = {10.1097/MEG.0b013e328133f2e7},
   year = {2007},
   type = {Ref–rence Type}
}

@article{
   author = {Morken, M. H. and Nysaeter, G. and Strand, E. A. and Hausken, T. and Berstad, A.},
   title = {Lactulose breath test results in patients with persistent abdominal symptoms following Giardia lamblia infection},
   journal = {Scand J Gastroenterol},
   volume = {43},
   number = {2},
   pages = {141-5},
   note = {Morken, Mette H
Nysaeter, Gunnar
Strand, Elisabeth A
Hausken, Trygve
Berstad, Arnold
Journal Article
England
Scand J Gastroenterol. 2008;43(2):141-5.},
   abstract = {OBJECTIVE: Bacterial overgrowth has been implicated in the pathogenesis of irritable bowel syndrome (IBS). The objective of this study was to investigate whether post-infectious IBS following Giardia lamblia infection is related to intestinal bacterial overgrowth, as diagnosed by the lactulose breath test (LBT). MATERIAL AND METHODS: Seventy-seven patients with persistent gastrointestinal complaints related to a recent outbreak of G. lamblia infection were included in the study. Despite one or several courses of treatment with metronidazole during the previous months, 23 of the patients were still stool positive for G. lamblia, whereas the remaining 54 patients had cleared the infection. All patients and 42 healthy volunteers underwent a LBT with 10 g lactulose, and their customary and post-LBT abdominal symptoms were scored. RESULTS: Ninety-five percent of the patients had IBS. Lactulose-induced hydrogen breath excretion was not significantly different in patients and controls. Customary and post-LBT symptoms were abnormally high in the patients, irrespective of both G. lamblia infection status and LBT results. Furthermore, lactulose challenge replicated the patients' customary complaints in 70% of the patients. CONCLUSIONS: Gastrointestinal complaints in patients with persistent or cleared giardiasis were unrelated to hydrogen breath excretion after lactulose challenge. Post-giardiasis IBS cannot be ascribed to intestinal bacterial overgrowth, as diagnosed by LBT.},
   keywords = {Abdominal Pain/chemically induced/microbiology/parasitology
Adolescent
Adult
Animals
Antiprotozoal Agents/therapeutic use
Breath Tests
Female
*Giardia lamblia
Giardiasis/*complications/drug therapy
Humans
Hydrogen/metabolism
Intestines/microbiology
*Irritable Bowel Syndrome/diagnosis/microbiology/parasitology
*Lactulose/adverse effects
Male
Metronidazole/therapeutic use
Middle Aged},
   ISSN = {0036-5521 (Print)
0036-5521},
   Accession Number = {17943632},
   DOI = {10.1080/00365520701673960},
   year = {2008},
   type = {Ref–rence Type}
}

@article{
   author = {Moskwa, A. and Chojnacki, J. and Wisiewska-Jarosinska, M. and Stec-Michalska, K. and Szadkowski, K. and Smigielski, J. and Chojnacki, C.},
   title = {[Serum serotonin concentration and urine 5-hydroxyindole acetic acid excretion in patients with irritable bowel syndrome]},
   journal = {Pol Merkur Lekarski},
   volume = {22},
   number = {131},
   pages = {366-8},
   note = {Moskwa, Anna
Chojnacki, Jan
Wisiewska-Jarosinska, Maria
Stec-Michalska, Krystyna
Szadkowski, Krzysztof
Smigielski, Janusz
Chojnacki, Cezary
English Abstract
Journal Article
Poland
Pol Merkur Lekarski. 2007 May;22(131):366-8.},
   abstract = {UNLABELLED: Serotonin (5-HT) is among other factors involved in gastrointestinal motility, secretion and visceral sensation. Available data suggest that secretion and metabolism of 5-HT may be disturbed in irritable bowel syndrome (IBS). Interpretation of these observations have been hampered by the variable methodology used and small numbers of patients involved in the previous studies. Aim of this study was to measure serum 5-TH concentration under fasting condition in patients with irritable bowel syndrome (IBS), compared with controls (K). The metabolite of serotonine--5-hydroxyindole acetic acid (5-HIAA) in urine was also assessed. METHODS: 71 subjects, aged 19-50 years were included in this study. Three groups were distinguished: group I (n=25)--healthy volunteers, group II (n=23)--patients with constipation predominant (IBS-C), group Ill (n=23)--subjects with diarrhea predominant irritable bowel syndrome (IBS-D). IBS was diagnosed according to Rome Ill Criteria. On the day of the experiment, patients received a standard meal (Nutridrink 6 x 300 kcal) and blood samples were collected during fasting. 5-HIAA concentration was determined in 24-hour urine collection. Concentration of 5-HT and 5-HIAA was measured by immunoenzyme ELISA method employing standard kits IBL nr RE59121 i RE59131 and Labsystems Multiscan detector. RESULTS: The average serotonin concentration during fasting was found in group I--156.67 +/- 49.12 ng/ml, in group II--221.73 +/- 91.56 ng/ml (p < 0.05), in group III--3.50 +/- 1.71 mg/24h. 5- HIAA concentration in urine was decreased in group Ill--3.50 +/- 1.71 mg/24 hrs (p < 0.05) and group II--4.37 +/- 2.95 mg/24 hrs compared with healthy volunteers--5.65 +/- 2.31 mg/24 hrs. CONCLUSION: (1) Serotonin concentration is increased in C-IBS and D-IBS patients. (2) Urine 5-hydroxyindole acetic acid excretion is decreased in IBS-subjects. (3) Disturbed metabolism of serotonin probably may play role in pathogenesis of functional bowel diseases.},
   keywords = {Adult
Constipation/blood/etiology/physiopathology/urine
Diarrhea/blood/etiology/physiopathology/urine
Down-Regulation
Fasting
Female
Humans
Hydroxyindoleacetic Acid/metabolism/*urine
Irritable Bowel Syndrome/*blood/complications/*urine
Male
Middle Aged
Postprandial Period
Serotonin/*blood
Up-Regulation},
   ISSN = {1426-9686 (Print)
1426-9686},
   Accession Number = {17679369},
   year = {2007},
   type = {Ref–rence Type}
}

@article{
   author = {Mulberg, A. E.},
   title = {Pharmaceutical industry in pediatric drug development: partners and collaborators with academia and the FDA},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {47},
   number = {5},
   pages = {711-3},
   note = {1536-4801
Mulberg, Andrew E
Journal Article
United States
J Pediatr Gastroenterol Nutr. 2008 Nov;47(5):711-3. doi: 10.1097/01.mpg.0000338970.57088.89.},
   keywords = {Child
Drug Industry/*trends
Humans
Irritable Bowel Syndrome/drug therapy
Pediatrics/*trends
United States
United States Food and Drug Administration},
   ISSN = {0277-2116},
   Accession Number = {18955888},
   DOI = {10.1097/01.mpg.0000338970.57088.89},
   year = {2008},
   type = {Ref–rence Type}
}

@article{
   author = {Nurko, S. and Di Lorenzo, C.},
   title = {Functional abdominal pain: time to get together and move forward},
   journal = {J Pediatr Gastroenterol Nutr},
   volume = {47},
   number = {5},
   pages = {679-80},
   note = {1536-4801
Nurko, Samuel
Di Lorenzo, Carlo
1R130K080536-01/PHS HHS/United States
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
United States
J Pediatr Gastroenterol Nutr. 2008 Nov;47(5):679-80. doi: 10.1097/MPG.0b013e31818936d1.},
   keywords = {Abdominal Pain/etiology/*physiopathology
Child
Gastrointestinal Diseases/*physiopathology
Humans
Irritable Bowel Syndrome/*physiopathology},
   ISSN = {0277-2116},
   Accession Number = {18955874},
   DOI = {10.1097/MPG.0b013e31818936d1},
   year = {2008},
   type = {Ref–rence Type}
}

@article{
   author = {Otten, C. M. and Kok, L. and Witteman, B. J. and Baumgarten, R. and Kampman, E. and Moons, K. G. and de Wit, N. J.},
   title = {Diagnostic performance of rapid tests for detection of fecal calprotectin and lactoferrin and their ability to discriminate inflammatory from irritable bowel syndrome},
   journal = {Clin Chem Lab Med},
   volume = {46},
   number = {9},
   pages = {1275-80},
   note = {Otten, Charlotte M T
Kok, Liselotte
Witteman, Ben J M
Baumgarten, Ruben
Kampman, Ellen
Moons, Karel G M
de Wit, Niek J
Journal Article
Germany
Clin Chem Lab Med. 2008;46(9):1275-80. doi: 10.1515/CCLM.2008.246.},
   abstract = {BACKGROUND: Ruling out somatic bowel disease, such as inflammatory bowel disease (IBD), is an important goal in the management of abdominal complaints. Endoscopy is commonly used but is invasive and expensive. Mucosal inflammation in IBD can be detected through fecal biomarkers, though the present enzyme-linked immunoabsorbent assay (ELISA) tests require laboratory facilities. We validated the diagnostic performance of two new fecal rapid tests (FRTs) for the detection of calprotectin and lactoferrin and assessed their potential to differentiate IBD from irritable bowel syndrome (IBS). METHODS: The calprotectin and lactoferrin FRTs and ELISA tests were performed on the fecal samples of 114 patients referred for endoscopy, 80% of whom had IBS and 20% IBD, and validated against the endoscopic diagnosis. RESULTS: The sensitivity and negative predictive value of the calprotectin FRT were both 100%, whereas they were 78% and 95%, respectively, for the lactoferrin FRT. The specificity and positive predictive value were slightly higher for the lactoferrin FRT. Both FRTs had similar diagnostic accuracy as the corresponding ELISA tests. CONCLUSIONS: The calprotectin and lactoferrin rapid tests are as good as the ELISA tests in detecting colonic inflammation. Given their simple use, FRTs can support the non-invasive exclusion of IBD, notably in primary care.},
   keywords = {Aged
Colon/pathology
Diagnosis, Differential
Endoscopy, Gastrointestinal
Enzyme-Linked Immunosorbent Assay
Feces/*chemistry
Female
Humans
Inflammation
Inflammatory Bowel Diseases/*diagnosis/pathology
Irritable Bowel Syndrome/*diagnosis/pathology
Lactoferrin/*analysis
Leukocyte L1 Antigen Complex/*analysis
Male
Middle Aged
Reproducibility of Results
Sensitivity and Specificity
Time Factors},
   ISSN = {1434-6621 (Print)
1434-6621},
   Accession Number = {18597588},
   DOI = {10.1515/cclm.2008.246},
   year = {2008},
   type = {Ref–rence Type}
}

@article{
   author = {Parkes, G. C.},
   title = {An overview of probiotics and prebiotics},
   journal = {Nurs Stand},
   volume = {21},
   number = {20},
   pages = {43-7},
   note = {Parkes, Gareth C
Journal Article
Review
England
Nurs Stand. 2007 Jan 24-30;21(20):43-7.},
   abstract = {This article reviews the origins and background of probiotics. Evidence for the potential mechanisms of probiotics and prebiotics, and their interactions with the gastrointestinal tract and the immune system are discussed. Evidence is examined for the use of probiotics to treat infantile diarrhoea, irritable bowel syndrome, inflammatory bowel disease and atopic dermatitis.},
   keywords = {Clinical Trials as Topic
Evidence-Based Medicine
Humans
Intestinal Diseases/nursing/therapy
Intestines/*microbiology
Nurse's Role
*Probiotics},
   ISSN = {0029-6570 (Print)
0029-6570},
   Accession Number = {17288356},
   DOI = {10.7748/ns2007.01.21.20.43.c4510},
   year = {2007},
   type = {Ref–rence Type}
}

@article{
   author = {Parkes, G. C. and Brostoff, J. and Whelan, K. and Sanderson, J. D.},
   title = {Gastrointestinal microbiota in irritable bowel syndrome: their role in its pathogenesis and treatment},
   journal = {Am J Gastroenterol},
   volume = {103},
   number = {6},
   pages = {1557-67},
   note = {1572-0241
Parkes, Gareth C
Brostoff, Jonathan
Whelan, Kevin
Sanderson, Jeremy D
Journal Article
Research Support, Non-U.S. Gov't
Review
United States
Am J Gastroenterol. 2008 Jun;103(6):1557-67. doi: 10.1111/j.1572-0241.2008.01869.x. Epub 2008 May 29.},
   abstract = {Irritable bowel syndrome (IBS) is a chronic disorder characterized by abdominal pain, change in bowel habit, and bloating. It has traditionally been viewed as a disorder of visceral hypersensitivity heavily influenced by stress, and therefore therapeutic strategies to date have largely reflected this. However, more recently, there is good evidence for a role of the gastrointestinal (GI) microbiota in its pathogenesis. Changes in fecal microbiota, the use of probiotics, the phenomenon of postinfectious IBS, and the recognition of an upregulated host immune system response suggest that an interaction between the host and GI microbiota may be important in the pathogenesis of IBS. This article explores the role of the GI microbiota in IBS and how their modification might lead to therapeutic benefit.},
   keywords = {Feces/microbiology
Humans
Intestinal Mucosa/*microbiology
Irritable Bowel Syndrome/*microbiology/pathology/*therapy
Probiotics/therapeutic use},
   ISSN = {0002-9270},
   Accession Number = {18513268},
   DOI = {10.1111/j.1572-0241.2008.01869.x},
   year = {2008},
   type = {Ref–rence Type}
}

@article{
   author = {Peterson, K. D.},
   title = {Inflammatory bowel disease: impact on early teenage years},
   journal = {Gastroenterol Nurs},
   volume = {31},
   number = {3},
   pages = {235-6},
   note = {1538-9766
Peterson, Kristin D
Case Reports
Journal Article
United States
Gastroenterol Nurs. 2008 May-Jun;31(3):235-6. doi: 10.1097/01.SGA.0000324117.86403.8e.},
   keywords = {Absenteeism
Adaptation, Psychological
Adolescent
Adolescent Behavior/psychology
Adolescent Nutritional Physiological Phenomena
Attitude to Health
Body Image
*Cost of Illness
Depression/etiology
Female
*Health Status
Humans
*Inflammatory Bowel Diseases/complications/prevention & control/psychology
Irritable Bowel Syndrome/complications/prevention & control/psychology
Nutrition Disorders/etiology
Patient Compliance/psychology
Psychology, Adolescent
Puberty, Delayed/etiology
Remission Induction
Stereotyping},
   ISSN = {1042-895x},
   Accession Number = {18542026},
   DOI = {10.1097/01.SGA.0000324117.86403.8e},
   year = {2008},
   type = {Ref–rence Type}
}

@article{
   author = {Piche, T. and Saint-Paul, M. C. and Dainese, R. and Marine-Barjoan, E. and Iannelli, A. and Montoya, M. L. and Peyron, J. F. and Czerucka, D. and Cherikh, F. and Filippi, J. and Tran, A. and Hebuterne, X.},
   title = {Mast cells and cellularity of the colonic mucosa correlated with fatigue and depression in irritable bowel syndrome},
   journal = {Gut},
   volume = {57},
   number = {4},
   pages = {468-73},
   note = {1468-3288
Piche, T
Saint-Paul, M C
Dainese, R
Marine-Barjoan, E
Iannelli, A
Montoya, M L
Peyron, J F
Czerucka, D
Cherikh, F
Filippi, J
Tran, A
Hebuterne, X
Journal Article
England
Gut. 2008 Apr;57(4):468-73. doi: 10.1136/gut.2007.127068. Epub 2008 Jan 14.},
   abstract = {BACKGROUND: A subset of patients with irritable bowel syndrome (IBS) have an increased number of mast cells (MCs) in the colonic mucosa. Psychological factors are believed to contribute to the course of IBS. AIMS: To examine associations between fatigue, depression and MCs of the colonic mucosa in IBS. METHODS: Colonic biopsies were taken from 50 Rome II IBS patients, 21 healthy controls and 11 depressed/fatigued patients without IBS. The cellularity of the lamina propria was determined as the number of inflammatory cells per high power field (hpf) through a 400x microscope. The Fatigue Impact Scale (FIS) and the short form Beck Depression Inventory (BDI) evaluated the severity of fatigue and depression. RESULTS: IBS patients had a significant increase in the cellularity of the lamina propria compared with controls or with depressed patients (mean (SD) 94.5 (48-110) vs 68 (58-82) and 78 (87-90) cells per hpf, p = 0.005 and p = 0.05, respectively), in particular of MCs (9.3 (5.6-11.7) vs 4.0 (2.7-6.8) and 4.3 (2.8-7.8) cells per hpf, p = 0.001 and p = 0.005, respectively). Both the FIS and BDI scores were significantly higher in IBS or in depressed patients than in controls (p<0.001). In IBS, the FIS score correlated significantly with the cellularity of the lamina propria (r = 0.51, p<0.0001) and MCs (r = 0.64, p<0.0001). In IBS, the BDI score correlated significantly with MCs (r = 0.29, p = 0.03). CONCLUSIONS: Elevated MCs counts are a key feature of the low-grade inflammatory infiltrate in the caecal mucosa of IBS. Fatigue and depression are associated with mucosal cell counts, in particular MCs, suggesting that psychological factors are associated with the low-grade inflammatory infiltrate in IBS.},
   keywords = {Adult
Aged
Biopsy
Colon/*pathology
Depression/etiology/*pathology
Fatigue/etiology/*pathology
Female
Humans
Intestinal Mucosa/pathology
Irritable Bowel Syndrome/complications/*pathology/psychology
Life Change Events
Male
Mast Cells/*pathology
Middle Aged
Psychiatric Status Rating Scales},
   ISSN = {0017-5749},
   Accession Number = {18194987},
   DOI = {10.1136/gut.2007.127068},
   year = {2008},
   type = {Ref–rence Type}
}

@article{
   author = {Pilipenko, V. I. and Isakov, V. A.},
   title = {[Comparative analysis of efficiency of the estimation of quality of life in patients with irritable bowel syndrome using questionnaires IBS-QOL and index BEST]},
   journal = {Eksp Klin Gastroenterol},
   number = {6},
   pages = {4-8},
   note = {Pilipenko, V I
Isakov, V A
Comparative Study
English Abstract
Journal Article
Russia (Federation)
Eksp Klin Gastroenterol. 2008;(6):4-8.},
   abstract = {AIM: To examine the power of correlation between IBS-QOL Questionnare and BEST index in patients with irritable bowel syndrome. METHODS: The IBS-QOL and BEST index were administered to 71 patients with IBS twice: before and after treatment. Statistical analysis to test the correlation between IBS-QOL and BEST index was performed using Spearman's rho coefficient. RESULTS: The study cohort included 71 patients with Rome-III IBS evaluated at the State Research Institute of Nutrition of Russian Academy of Medical Sciences (mean age 41,4; mean IBS-QOL = 65,6; 76% women). The mean completion + scoring time for BEST was under 3 minutes vs 25 minutes for IBS-QOL. There was a striking correlation (r = - 0,8) between BEST and IBS-QOL results. CONCLUSIONS: BEST is a concise, rapidly completed, point-of-care IBS severity index that demonstrates large correlation with well-validated instrument for assessing QOL (IBS-QOL) in IBS patients.},
   keywords = {Adolescent
Adult
Aged
Female
Humans
Irritable Bowel Syndrome/diagnosis/*therapy
Male
Middle Aged
Outcome Assessment (Health Care)/*methods
*Quality of Life/psychology
Severity of Illness Index
Surveys and Questionnaires/*standards
Young Adult},
   ISSN = {1682-8658 (Print)
1682-8658},
   Accession Number = {19334419},
   year = {2008},
   type = {Ref–rence Type}
}

@article{
   author = {Quigley, E. M.},
   title = {Probiotics in irritable bowel syndrome: an immunomodulatory strategy?},
   journal = {J Am Coll Nutr},
   volume = {26},
   number = {6},
   pages = {684s-90s},
   note = {1541-1087
Quigley, Eamonn M M
Journal Article
Review
United States
J Am Coll Nutr. 2007 Dec;26(6):684S-90S.},
   abstract = {The clear delineation of a post-infective variety of IBS, as well as the description, in a number of studies, of evidence of low-grade inflammation and immune activation in IBS, suggest a role for a dysfunctional relationship between the indigenous flora and the host in IBS and, accordingly, provide a clear rationale for the use of probiotics in this disorder. Other modes of action, including bacterial displacement and alterations in luminal contents, are also plausible. While clinical evidence of efficacy is now beginning to emerge, a review of available trials emphasizes the importance of a clear definition of strain selection, dose and viability. The possible roles of co-therapy or sequential therapy with antibiotics, probiotics, prokinetics, or other agents also deserves further study. The role of the enteric flora is evidently an area of great potential in IBS; we are on the threshold of a new era of research and therapy for this common disorder.},
   keywords = {Evidence-Based Medicine
Humans
*Immunity, Mucosal
Intestinal Mucosa/microbiology/pathology
Irritable Bowel Syndrome/*drug therapy/immunology/*microbiology
Probiotics/*therapeutic use
Severity of Illness Index
Treatment Outcome},
   ISSN = {0731-5724},
   Accession Number = {18187434},
   year = {2007},
   type = {Ref–rence Type}
}

@article{
   author = {Ranjbaran, Z. and Keefer, L. and Farhadi, A. and Stepanski, E. and Sedghi, S. and Keshavarzian, A.},
   title = {Impact of sleep disturbances in inflammatory bowel disease},
   journal = {J Gastroenterol Hepatol},
   volume = {22},
   number = {11},
   pages = {1748-53},
   note = {Ranjbaran, Ziba
Keefer, Laurie
Farhadi, Ashkan
Stepanski, Edward
Sedghi, Shahriar
Keshavarzian, Ali
Journal Article
Multicenter Study
Australia
J Gastroenterol Hepatol. 2007 Nov;22(11):1748-53.},
   abstract = {BACKGROUND: Normal sleep is paramount for a healthy lifestyle and high quality of life. Sleep modulates the immune system and thus affects the course of several chronic inflammatory conditions. There are no reported studies that address the role of sleep disturbance in the course of inflammatory bowel disease (IBD). The aim of this study was to characterize sleep disturbance in IBD using validated measures of sleep and quality of life. METHODS: A self-administered, mail-in questionnaire package was sent to 205 subjects after a brief instruction. The questionnaire package was composed of the Pittsburgh Sleep Quality Index (PSQI), a measure of disease severity and the IBD-Quality of Life Questionnaire. A total of 119 subjects were recruited (58% response rate): 80 with inactive IBD, 24 with irritable bowel syndrome (IBS) and 15 healthy controls. RESULTS: The IBD subjects reported significantly prolonged sleep latency, frequent sleep fragmentation, higher rate of using sleeping pills, decreased day-time energy, increased tiredness and poor overall sleep quality compared to healthy controls. The abnormal sleep patterns in IBD subjects were similar to IBS subjects. The reported sleep quality was correlated with IBD disease severity score (r(2) = 0.55, P = 0.02). Both IBD and IBS subjects thought that sleep and their disease status were correlated. CONCLUSION: The results show that IBD patients have significant sleep disturbance even when their disease is not active. This problem might affect quality of life, gastrointestinal symptoms and coping ability, and might potentially modify disease severity or increase risk of flare-up. Regardless of the primary or secondary origin of this problem, sleep disturbance should be addressed in the clinical management of patients with IBD.},
   keywords = {Adult
Aged
Aged, 80 and over
Case-Control Studies
Colitis, Ulcerative/complications/physiopathology
Crohn Disease/complications/physiopathology
Female
Humans
Inflammatory Bowel Diseases/complications/*physiopathology
Irritable Bowel Syndrome/*physiopathology
Male
Middle Aged
*Quality of Life
*Sleep
Sleep Wake Disorders/*etiology/physiopathology
Surveys and Questionnaires
United States},
   ISSN = {0815-9319 (Print)
0815-9319},
   Accession Number = {17914945},
   DOI = {10.1111/j.1440-1746.2006.04820.x},
   year = {2007},
   type = {Ref–rence Type}
}

@article{
   author = {Remes-Troche, J. M. and Adames, K. and Castillo-Rodal, A. I. and Ramirez, T. and Barreto-Zuniga, R. and Lopez-Vidal, Y. and Uscanga, L. F.},
   title = {Intraepithelial gammadelta+ lymphocytes: a comparative study between celiac disease, small intestinal bacterial overgrowth, and irritable bowel syndrome},
   journal = {J Clin Gastroenterol},
   volume = {41},
   number = {7},
   pages = {671-6},
   note = {Remes-Troche, Jose Maria
Adames, Karina
Castillo-Rodal, Antonia I
Ramirez, Teresa
Barreto-Zuniga, Rafael
Lopez-Vidal, Yolanda
Uscanga, Luis F
Comparative Study
Journal Article
United States
J Clin Gastroenterol. 2007 Aug;41(7):671-6.},
   abstract = {BACKGROUND: Intraepithelial lymphocytes (IELs) phenotyping has emerged as a useful test in intestinal pathology. In celiac disease (CD), a permanent and marked increase of gammadelta+ IELs has been described. However, there is a lack of knowledge about this peculiar IELs population in other intestinal pathologies. AIM: To analyze the percentage of IELs, specifically gammadelta+ IELs subset, present in duodenal mucosa biopsies from patients with CD and compare it with those obtained from patients with small intestinal bacterial overgrowth (SIBO) or irritable bowel syndrome (IBS). METHODS: Twelve patients with untreated CD, 8 patients with SIBO, and 10 patients with diarrhea-predominant IBS were evaluated. All subjects underwent upper endoscopy for mucosal biopsy and jejunal aspirate. From 2 small bowel biopsies, intraepithelial cells were isolated and labeled with the following monoclonal antibodies CD103-PE (phycoerythrin), CD3-FITC (fluoresecein isothio-cynate), CD-7R-PE, CD45RO-APC (allophycocyanin), and TcR gammadelta-FITC. Flow cytometry analysis was performed on a standard FACScan. Total and IELs subset counts were expressed as percentage. RESULTS: Mean total IELs percentage was 16.7+/-6% in IBS, 25.4+/-17% in SIBO, and 26+/-13% in CD patients (P=0.2). CD and SIBO patients, had significantly higher percentages of gammadelta+ IELs (15.7+/-13% and 14.6+/-8%) than IBS subjects (4.1+/-2.5%, P<0.05). There was no difference between CD and SIBO (P=0.6). CONCLUSIONS: An increased density of gammadelta+ IELs is typical, but not specific for CD. A similar increase was observed in subjects with SIBO. Our findings suggest that this unique T-cell population might have a key role against intestinal bacterial infections.},
   keywords = {Adult
Blind Loop Syndrome/*immunology
Celiac Disease/*immunology
Female
Humans
Irritable Bowel Syndrome/*immunology
Lymphocytes/*immunology
Male
Middle Aged
Prospective Studies
Receptors, Antigen, T-Cell, gamma-delta},
   ISSN = {0192-0790 (Print)
0192-0790},
   Accession Number = {17667051},
   DOI = {10.1097/01.mcg.0000247994.34957.ae},
   year = {2007},
   type = {Ref–rence Type}
}

@article{
   author = {Roka, R. and Ait-Belgnaoui, A. and Salvador-Cartier, C. and Garcia-Villar, R. and Fioramonti, J. and Eutamene, H. and Bueno, L.},
   title = {Dexamethasone prevents visceral hyperalgesia but not colonic permeability increase induced by luminal protease-activated receptor-2 agonist in rats},
   journal = {Gut},
   volume = {56},
   number = {8},
   pages = {1072-8},
   note = {Roka, Richard
Ait-Belgnaoui, Afifa
Salvador-Cartier, Christel
Garcia-Villar, Raphael
Fioramonti, Jean
Eutamene, Helene
Bueno, Lionel
Journal Article
England
Gut. 2007 Aug;56(8):1072-8. Epub 2007 Feb 19.},
   abstract = {BACKGROUND: Low-grade inflammation may play a role in the pathogenesis of irritable bowel syndrome (IBS). Although corticosteroids are potent inhibitors of inflammatory processes, only one study with corticosteroids in patients with postinfectious IBS exists, which suggests that prednisolone is not an effective treatment for IBS symptoms. AIM: To evaluate whether dexamethasone treatment prevents protease-activated receptor-2 (PAR-2) activation-induced visceral hyperalgesia and increased permeability in rats, and to determine whether the effects involve colonic mast cells. METHODS: Abdominal contractions provoked by rectal distension were recorded in rats equipped with intramuscular electrodes. Changes in visceral hypersensitivity provoked by intracolonic administration of PAR-2-activating peptide (SLIGRL; H-serine-leucine-isoleucine-glycine-arginine-leucine-OH), changes in colonic mucosal rat mast cell protease-II (RMCP-II) content, mast cell count and PAR-2 expression were measured after a 4-day treatment with dexamethasone (1 mg/day/rat intraperitoneally) or its vehicle (water). The effect of mast cell stabiliser (doxantrazole, 1 mg/kg intraperitoneally, 2 h before and 6 h after intracolonic infusion of SLIGRL) on SLIGRL-induced visceral hyperalgesia was also assessed. The effects of SLIGRL and a mast cell degranulator (compound 48/80) on the permeability of colonic strips from vehicle- or dexamethasone-treated rats were investigated in Ussing chambers. RESULTS: 4 days of dexamethasone as well as doxantrazole diminished the SLIGRL-induced hyperalgesia for all volumes of distension. This effect of dexamethasone was accompanied by a reduced responsiveness of colonic permeability to compound 48/80, and decreased RMCP-II content and mast cell number. Dexamethasone treatment did not influence colonic mucosal PAR-2 expression and permeability responsiveness to SLIGRL. CONCLUSIONS: Dexamethasone treatment improves PAR-2 agonist-induced visceral hypersensitivity but does not prevent PAR-2 agonist-induced increase in colonic permeability in rats. This effect is coupled with a reduction of colonic mast cell number and RMCP-II contents.},
   keywords = {Animals
Cell Count
Colon/*drug effects/pathology/physiopathology
Dexamethasone/*administration & dosage
Glucocorticoids/*administration & dosage
Hyperalgesia/pathology/physiopathology/*prevention & control
Immunohistochemistry/methods
Infusions, Parenteral
Injections, Intraperitoneal
Intestinal Mucosa/drug effects/enzymology/physiopathology
Male
Mast Cells/drug effects/physiology
Metalloendopeptidases/analysis
Oligopeptides/administration & dosage
Permeability/drug effects
Rats
Rats, Wistar
Receptor, PAR-2/*agonists
Thioxanthenes/administration & dosage
Viscera/*drug effects/physiopathology
Xanthones/administration & dosage},
   ISSN = {0017-5749 (Print)
0017-5749},
   Accession Number = {17309885},
   DOI = {10.1136/gut.2006.115352},
   year = {2007},
   type = {Ref–rence Type}
}

@article{
   author = {Roka, R. and Rosztoczy, A. and Leveque, M. and Izbeki, F. and Nagy, F. and Molnar, T. and Lonovics, J. and Garcia-Villar, R. and Fioramonti, J. and Wittmann, T. and Bueno, L.},
   title = {A pilot study of fecal serine-protease activity: a pathophysiologic factor in diarrhea-predominant irritable bowel syndrome},
   journal = {Clin Gastroenterol Hepatol},
   volume = {5},
   number = {5},
   pages = {550-5},
   note = {1542-7714
Roka, Richard
Rosztoczy, Andras
Leveque, Mathilde
Izbeki, Ferenc
Nagy, Ferenc
Molnar, Tamas
Lonovics, Janos
Garcia-Villar, Rafael
Fioramonti, Jean
Wittmann, Tibor
Bueno, Lionel
Journal Article
Research Support, Non-U.S. Gov't
United States
Clin Gastroenterol Hepatol. 2007 May;5(5):550-5. Epub 2007 Mar 2.},
   abstract = {BACKGROUND & AIMS: The pathogenesis of irritable bowel syndrome (IBS) remains only partially understood, and no specific or universally effective patient management procedure has been developed to date. Our study was designed to evaluate if colonic luminal serine-proteases may be a relevant pathophysiologic marker of IBS. METHODS: Fecal samples of 38 IBS patients, 15 patients with ulcerative colitis (UC), and 15 healthy controls were studied. Fecal serine-protease activity was determined photometrically by using azocasein as a proteolytic substrate; fecal pancreatic elastase-1 and mast cell tryptase content were measured by enzyme-linked immunosorbent assay. Fecal secretory leukocyte protease inhibitor concentration was determined by enzyme-linked immunosorbent assay in control subjects and in patients with diarrhea-predominant IBS. RESULTS: Fecal serine-protease activity was 3-fold higher in patients with diarrhea-predominant IBS than in both controls and IBS patients with either constipation or alternating bowel habits. Fecal serine-protease activity was not correlated with the frequency of bowel movements in all groups. Increased serine-protease activity also was detected in stools of UC patients. No significant difference was observed in the fecal mast cell tryptase and pancreatic elastase concentrations between all groups, or in the fecal secretory leukocyte protease inhibitor concentration between controls and diarrhea-predominant IBS patients. CONCLUSIONS: Fecal serine-protease activity is increased markedly in patients with diarrhea-predominant IBS. This increase, however, is not coupled with changes in either mast cell tryptase or pancreatic elastase concentrations. Thus, serine-protease activity in the colon may be a pathophysiologic factor in the development of diarrhea-predominant IBS.},
   keywords = {Adult
Aged
Case-Control Studies
Colitis, Ulcerative/*enzymology/etiology/physiopathology
Diarrhea/*enzymology/etiology/physiopathology
Feces/*chemistry
Female
Humans
Intestinal Mucosa/enzymology
Male
Middle Aged
Pilot Projects
Secretory Leukocyte Peptidase Inhibitor/metabolism
Serine Endopeptidases/*metabolism},
   ISSN = {1542-3565},
   Accession Number = {17336590

repository: KociOrges/pytag

repo_name: KociOrges/pytag