Risultati per: Trattamento della sindrome dell'intestino irritabile (IBS)

Objective
Dietary therapies for irritable bowel syndrome (IBS) have received increasing interest but predicting which patients will benefit remains a challenge due to a lack of mechanistic insight. We recently found evidence of a role for the microbiota in dietary modulation of pain signalling in a humanised mouse model of IBS. This randomised cross-over study aimed to test the hypothesis that pain relief following reduced consumption of fermentable carbohydrates is the result of changes in luminal neuroactive metabolites.

Design
IBS (Rome IV) participants underwent four trial periods: two non-intervention periods, followed by a diet low (LFD) and high in fermentable carbohydrates for 3 weeks each. At the end of each period, participants completed questionnaires and provided stool. The effects of faecal supernatants (FS) collected before (IBS FS) and after a LFD (LFD FS) on nociceptive afferent neurons were assessed in mice using patch-clamp and ex vivo colonic afferent nerve recording techniques.

Results
Total IBS symptom severity score and abdominal pain were reduced by the LFD (N=25; p

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We thank Rej et al for their interest in our DOMINO trial paper.1 2 In their letter, they point out that while the DOMINO application yields a statistically significant gain in responder rate over traditional medical therapy with otilonium bromide, the numerical difference is limited, as it amounts to only 10% at weeks 4 and 8. We want to point out that these margins are in the order of magnitude of the gain in response rate over placebo in recent trials with novel drugs for the treatment of Irritable Bowel Syndrome (IBS) that have seen regulatory approval.3–6 In addition, the attractiveness of the dietary approach in our view is not predominantly determined by superior efficacy compared with medical therapy. As the patient, through the diet smartphone application, achieves the ability to control symptoms using relatively simple dietary…

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