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IBS quick tip -taking a fiber supplements and medications new
      #370106 - 08/30/13 11:54 AM
HeatherAdministrator

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Can you take a soluble fiber supplement with medications?

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IBS Quick Tip - Aloe, Senna, and Cascara for IBS? new
      #370159 - 09/10/13 11:20 AM
HeatherAdministrator

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Aloe, Senna, and Cascara for IBS?

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Vitamins and IBS new
      #370977 - 03/11/14 02:10 PM
HeatherAdministrator

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Vitamins and IBS

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Aloe vera in Patients with Irritable Bowel Syndrome new
      #372129 - 05/27/15 02:39 PM
HeatherAdministrator

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ISRN Gastroenterol. 2011;2011:206103. doi: 10.5402/2011/206103. Epub 2010 Oct 11.

A Randomised, Cross-Over, Placebo-Controlled Study of Aloe vera in Patients with Irritable Bowel Syndrome: Effects on Patient Quality of Life.

Hutchings HA1, Wareham K, Baxter JN, Atherton P, Kingham JG, Duane P, Thomas L, Thomas M, Ch'ng CL, Williams JG.
Author information
Abstract

Background. Irritable bowel syndrome (IBS) is a chronic, difficult to treat condition. The efficacy of Aloe vera in treating IBS symptoms is not yet proven. The purpose of this study was to determine if Aloe vera is effective in improving quality of life. Methods. A multicentre, randomised, double-blind, cross-over placebo controlled study design. Patients were randomised to Aloe vera, wash-out, placebo or placebo, washout, Aloe vera. Each preparation (60 mL) was taken orally twice a day. Patient quality of life was measured using the Gastrointestinal Symptoms Rating Score, Irritable Bowel Syndrome Quality of Life, EuroQol and the Short-Form-12 at baseline and treatment periods 1 and 2. Results. A total of 110 patients were randomised, but only 47 completed all questionnaires and both study arms. Statistical analysis showed no difference between the placebo and Aloe vera treatment in quality of life. Discussion. This study was unable to show that Aloe vera was superior to placebo in improving quality of life. Drop outs and other confounding factors may have impacted on the power of the study to detect a clinically important difference. Conclusion. This study failed to find Aloe vera superior to placebo in improving quality of life proven Irritable Bowel Syndrome patients.

PMID:
21991499
[PubMed]
PMCID:
PMC3168391

http://www.ncbi.nlm.nih.gov/pubmed/21991499

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Trial of aloe vera for irritable bowel syndrome new
      #372130 - 05/27/15 02:44 PM
HeatherAdministrator

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Int J Clin Pract. 2006 Sep;60(9):1080-6. Epub 2006 Jun 2.
Randomised double-blind placebo-controlled trial of aloe vera for irritable bowel syndrome.

Davis K1, Philpott S, Kumar D, Mendall M.
Author information
Abstract

Aloe vera (AV) is suggested to be beneficial in treating irritable bowel syndrome (IBS) symptoms, but no scientific trials exist to confirm this. We aim to assess the efficacy of AV on IBS in refractory secondary care patients. Patients with IBS were randomised to receive AV or matching placebo for a month. Symptoms were assessed at baseline, 1 and 3 months. Fifty-eight patients randomised, 49 completed the protocol to 1 month and 41 to 3 months. Eleven of thirty-one (35%) AV patients, and 6 of 27 (22%) placebo patients responded at 1 month (p = 0.763). Diarrhoea predominant patients showed a trend towards a response to treatment at 1 month (10/23 V 2/14, p = 0.07). There was no evidence that AV benefits patients with IBS. However, we could not rule out the possibility that improvement occurred in patients with diarrhoea or alternating IBS whilst taking AV. Further investigations are warranted in patients with diarrhoea predominant IBS, in a less complex group of patients.

PMID:
16749917
[PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/16749917

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Vitamin D deficiency in children and adults with IBS new
      #373579 - 04/07/17 03:18 PM
HeatherAdministrator

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New Medical Research Shows Vitamin D Deficiency Observed in Children, Adolescents and Adults with Irritable Bowel Syndrome (IBS), Calling Attention to Managing Nutritional Requirements Related to IBS

- New study notes that children and adolescents with Irritable Bowel Syndrome (IBS) have a high incidence of vitamin D deficiency

- Corroborates earlier evidence of vitamin D deficiency among adults with IBS

- Since vitamin D deficiency can lead to increased risk of decreased bone mass, nutritional requirements related to IBS need attention

- Intestinal malabsorption emerging as an underlying factor in IBS

News provided by
IM HealthScience

Apr 05, 2017, 09:04 ET

Share this article

BOCA RATON, Fla., April 5, 2017 /PRNewswire/ -- A recently published case-controlled study, entitled "Vitamin D status in pediatric irritable bowel syndrome,"1 found more than 90 percent of pediatric patients with Irritable Bowel Syndrome (IBS) were deficient in vitamin D. According to the lead study author from UMass Memorial Health Care, Benjamin U. Nwosu, M.D., these children "are definitely at risk for decreased bone mass." The study was published on February 13, 2017, in PLOS ONE, a peer-reviewed, open-access scientific journal published by the Public Library of Science (PLOS), which covers primary research within science and medicine.

Dr. Nwosu said that he "was surprised that IBS had the highest prevalence of vitamin D deficiency of all gastrointestinal disorders we have studied in the past 5 years."

The study authors noted, "There is a much higher prevalence of vitamin D deficiency (in IBS) compared to IBD (Inflammatory Bowel Disease) and other malabsorption syndromes."

"Clinicians should immediately increase their surveillance for vitamin D deficiency in patients with IBS and initiate appropriate vitamin D supplementation in cases of deficiency," said Dr. Nwosu.

Vitamin D Deficiency in Adults With IBS
A previous analysis in adults conducted with patients with IBS and a healthy control group without IBS, entitled "Vitamin D Deficiency in Patients with Irritable Bowel Syndrome: Does it Exist?"2, showed that vitamin D deficiency was highly prevalent in patients with IBS, and that vitamin D supplementation should be considered as part of the therapeutic protocol in patients with IBS. The 2015 study was published in the Oman Medical Journal, a peer-reviewed, open-access international journal.

Yasir Khayyat, M.D., the lead study author, concluded that vitamin D supplementation could play a therapeutic role in control of IBS. He said, "With an enhanced attention on the role of vitamin D deficiency in the pathogenesis of several chronic illnesses, deficiency of vitamin D in IBS has recently caught the interest of medical professionals. There have been numerous attempts of therapeutic application of vitamin D to improve IBS symptoms. More research is needed to establish the therapeutic role of vitamin D in the management of IBS patients and deficiency should be addressed in the diagnosis and the treatment of the condition."

Another double-blind, placebo-controlled pilot study recently was conducted by the University of Sheffield (U.K.). This study of adults with IBS, entitled "Vitamin D associates with improved quality of life in participants with irritable bowel syndrome: outcomes from a pilot trial,"3 showed that 78 percent of the IBS patients in the study were vitamin D deficient, and, at baseline, circulating vitamin D levels were correlated with IBS patients' quality of life. The lead author of the study, Simon Tazzyman, M.D., hypothesized that vitamin D supplementation may improve IBS symptoms. Study results revealed that vitamin D supplementation significantly improved vitamin D levels in both the placebo and vitamin D supplementation arms. However, in this study, the two arms did not separate when it came to IBS symptoms' severity. The 2016 study was published in the BMJ Open Gastroenterology, an online-only, peer-reviewed open access gastroenterology journal, dedicated to publishing high-quality medical research from all disciplines and therapeutic areas of gastroenterology.

http://www.prnewswire.com/news-releases/new-medical-research-shows-vitamin-d-deficiency-observed-in-children-adolescents-and-adults-with-irritable-bowel-syndrome-ibs-calling-attention-to-managing-nutritional-requirements-related-to-ibs-300434590.html

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Review article: the physiological effects and safety of peppermint oil and its efficacy in irritable bowel syndrome new
      #373654 - 01/26/18 12:06 PM
HeatherAdministrator

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Review article: the physiological effects and safety of peppermint oil and its efficacy in irritable bowel syndrome and other functional disorders
Authors

First published: 26 January 2018Full publication history
DOI: 10.1111/apt.14519 View/save citation

Summary
Background

Peppermint oil has been used for centuries as a treatment for gastrointestinal ailments. It has been shown to have several effects on gastrointestinal physiology relevant to clinical care and management.
Aim

To review the literature on peppermint oil regarding its metabolism, effects on gastrointestinal physiology, clinical use and efficacy, and safety.
Methods

We performed a PubMed literature search using the following terms individually or in combination: peppermint, peppermint oil, pharmacokinetics, menthol, oesophagus, stomach, small intestine, gallbladder, colon, transit, dyspepsia, nausea, abdominal pain, and irritable bowel syndrome. Full manuscripts evaluating peppermint oil that were published through 15 July 2017 were reviewed. When evaluating therapeutic indications, only randomised clinical trials were included. References from selected manuscripts were used if relevant.
Results

It appears that peppermint oil may have several mechanisms of action including: smooth muscle relaxation (via calcium channel blockade or direct enteric nervous system effects); visceral sensitivity modulation (via transient receptor potential cation channels); anti-microbial effects; anti-inflammatory activity; modulation of psychosocial distress. Peppermint oil has been found to affect oesophageal, gastric, small bowel, gall-bladder, and colonic physiology. It has been used to facilitate completion of colonoscopy and endoscopic retrograde cholangiopancreatography. Placebo controlled studies support its use in irritable bowel syndrome, functional dyspepsia, childhood functional abdominal pain, and post-operative nausea. Few adverse effects have been reported in peppermint oil trials.
Conclusion

Peppermint oil is a natural product which affects physiology throughout the gastrointestinal tract, has been used successfully for several clinical disorders, and appears to have a good safety profile.

Full article here http://onlinelibrary.wiley.com/doi/10.1111/apt.14519/full

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Glutamine supplements improve symptoms of postinfectious IBS-Diarrhea new
      #373729 - 08/22/18 02:35 PM
HeatherAdministrator

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Glutamine supplements improve symptoms of postinfectious IBS-D

Zhou Q, et al. Gut. 2018;doi:10.1136/gutjnl-2017-315136.
August 21, 2018

Oral dietary glutamine supplements helped patients improve symptoms of postinfectious diarrhea predominant irritable bowel syndrome, according to research published in Gut.

QiQi Zhou, MD, PhD, MBA, of the department of medicine at Tulane School of Medicine, and colleagues hypothesized that glutamine could potentially be used as a therapy for IBS, an area where current treatments are “unsatisfactory.”
See Also

Vitamin D supplements may ease IBS symptoms
L-glutamine reduces painful crises associated with sickle cell disease
Top stories in gastroenterology: Stressful events, ultra-processed foods linked to increased risk for IBS

“Glutamine, an essential amino acid in humans, is a major energy source for rapidly dividing epithelial cells of the gastrointestinal tract,” they wrote. “Depletion of glutamine during infection or illness leads to atrophy of intestinal epithelial cells and intestinal hyperpermeability.”

Zhou and colleagues tested the efficacy and safety of an oral glutamine supplement in a randomized, placebo-controlled trial. They included patients aged 18 to 72 with IBS-D and documentation of an enteric infection.

Patients received either a glutamine supplement (n = 54) or placebo (n = 52) for 8 weeks. The primary endpoint was a reduction of at least 50 points on the Irritable Bowel Syndrome Severity Scoring System (IBS-SS).

More patients in the glutamine group achieved the primary endpoint compared with patients in the placebo group (79.6% vs. 5.8%; P < .0001). Patients in the glutamine group also achieved better mean results in the secondary outcome measures: IBS-SS score at 8 weeks (301 vs. 181; P < .0001); daily bowel movement frequency (5.4 vs. 2.9; P < .0001); Bristol stool scale (6.5 vs. 3.9; P < .0001); and intestinal permeability (0.11 vs. 0.05; P < .0001).

Zhou and colleagues also found that adverse events were low and similar in both groups and observed no serious adverse events.

Researchers wrote that glutamine’s mechanism might involve normalization and hyperpermeability. They called for further research to determine the long-term efficacy of a glutamine treatment for IBS.

“Our results and others suggest that glutamine’s mechanism of action may be restoring normal intestinal permeability, which leads to improved gastrointestinal symptoms,” the researchers wrote. “Additional evidence suggests that glutamine directly modulates intestinal permeability in patients with IBS-D.” " by Alex Young

Disclosures: The authors report no relevant financial disclosures.

https://www.healio.com/gastroenterology/irritable-bowel-syndrome/news/online/%7B63383858-ea7c-4af9-b057-9e214ea5ebce%7D/glutamine-supplements-improve-symptoms-of-postinfectious-ibs-d

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Medical cannabis: Promising uses supported by medical data new
      #373824 - 03/05/19 12:58 PM
HeatherAdministrator

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Medical cannabis: Promising uses supported by medical data

Kristin Bundy, for MDLinx ' March 01, 2019

Over the past several years, legalization of medical marijuana has caught on like wildfire across the United States. The latest three states to approve medical use Michigan, Missouri, and Utah were added to the list as of the 2018 mid-term elections. That makes 34 states that have legalized cannabis for medicinal use through February 2019.

Despite the quick uptick of legislative and public approval, scientific evidence backed by large randomized, controlled trials is lacking. In addition, there are no straight forward data to help clinicians determine which formulation of cannabis to use, what route of administration is most appropriate, how often it should be dosed and for how long, and what is the appropriate ratio of tetrahydrocannabinol (THC) to cannabidiol (CBD) the two most prominent ligands used for therapeutic purposes.

While public adoption of medical cannabis seems to be progressing faster than researchers can prepare the trials, it is useful to see what data are available and for what conditions medical marijuana may have a promising future.

Autism spectrum disorder (ASD): Earlier this year, researchers from Israel, published an observational study in Nature Scientific Reports, with prospectively collected data, on medical cannabis use in children with ASD.

Interestingly, these authors noted that the impetus for this study came from learning that parents of severely autistic children started turning to medical marijuana for relief after seeing the results of cannabis treatment on symptoms like anxiety, aggression, panic, tantrums and self-injurious behavior in children with epilepsy.

The study focused on the safety and efficacy of medical cannabis in 188 young subjects (median age: 13; 82% male) between 2015 ad 2017. Most patients were treated sublingually with cannabis oil containing 30% CBD and 1.5% THC. After 6 months of treatment, investigators reported that 30% of patients had a significant improvement in their condition, 54% had a moderate change, 6% had a slight change, and 9% had no change. The most common side effect was restlessness (7%).

Chronic disease: In mid-February 2019, researchers from Italy published retrospective, observational, singe-cohort data on the safety and efficacy of a natural preparation of cannabis, which contains THC but not CBD, and is administered sublingually.

Twenty patients (age range: 18-80 years; mean age: 40 years; 12 women/8 men) were enrolled through a compassionate use program in Italy. Each participant had chronic and severe symptoms of one of the following conditions: neurologic diseases, cancer, fibromyalgia, multiple sclerosis, dystrophy syndrome, insomnia, chronic obstructive pulmonary disease, and hernia.

For 3 months, they took sublingual doses of the galenical oil twice daily, starting at a low dose of 0.5 mL/d, and gradually titrating up to the highest recommended dose of 1 mL/d.

Monthly questionnaires revealed a significant decrease in pain, improved social functioning and general health, and restored physical function. Researchers also observed significant reductions in insomnia and significant improvements in mood and concentration. No adverse events were reported.

Chronic pain and sleep measures: Experts in anesthesia and pain management, led by Ivan Urits, MD, of Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, published a review article on available data of cannabis pharmaceutical derivatives in chronic, difficult-to-treat conditions.

The derivative with the most data in humans that they reviewed was nabiximols, an oromucosal cannabinoid spray that predominantly contains a mix of THC and CBD. The spray is approved in Canada and many European countries as add-on treatment in patients with multiple sclerosis to reduce spasticity.

The review included the following results with nabiximols reported from various studies:

Reduced patient-reported MS-related spasticity and improved sleep
Reduced MS-related pain after 4 weeks, with additional reductions at 14 weeks
Improved sleep in patients with chronic, cancer-related pain
Reduced peripheral neuropathic pain and improved sleep and allodynia
Reduced pain and improved quality of sleep in patients with rheumatoid arthritis

Inflammatory bowel disease (IBD): In October 2018, Jami Kinnucan, MD, assistant professor of medicine at the University of Michigan, Ann Arbor, MI, published a Q&A article in Gastroenterology & Hepatology on the use of medial cannabis in IBD.

Dr. Kinnucan detailed some of the findings that have been reported, including:

A survey-based study demonstrating improved abdominal pain, appetite, nausea, and diarrhea
A prospective pilot study that showed a reduction in pain and symptoms and improved general health perception, social functioning, and the ability to work
The first randomized, controlled trial of medical marijuana in Crohn's disease, which showed that, in 21 patients who smoked two cannabis cigarettes/day for 8 weeks, Crohn's Disease Activity Index scores significantly improved vs placebo; nearly half of patients experienced clinical remission, and a quarter were able to discontinue corticosteroids

On the horizon

Time and time again, authors who have published preliminary results have ultimately concluded by emphasizing the need for larger, prospective, randomized, controlled trials. The problem in conducting these larger more rigorous trials in the United States revolves around the illegality of cannabis under current federal legislature.

Nonetheless, the National Institutes of Health (NIH) have made a strong commitment to support cannabis research in the US. The latest data available from the NIH report nearly $140 million dedicated to 330 medical cannabis projects as of fiscal year 2017. This funding applies to bench, animal, and human preclinical and clinical studies that examine the chemical, physiological, and therapeutic properties of cannabinoids and the physiological systems they affect, according to the NIH website.

NIH is also funding studies that analyze regional health and social factors related to the changing laws on cannabis use.

Just as some of the preliminary data (and patient anecdotal accounts) indicate a promising future for the use of medical cannabis, so does the dedication of millions of dollars from the NIH to further research. Perhaps, soon, our scientific understanding of medical marijuana will catch up with public support.

https://www.mdlinx.com/internal-medicine/article/3490?utm_source=in-house&utm_medium=message&utm_campaign=itn-cannabis-mar3



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