Slowly improving glycemic control following gestational diabetes increases risk for shoulder dystocia

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Key clinical point: Risk for shoulder dystocia was higher among women with gestational diabetes who showed a slowly improving glycemic control trajectory, highlighting the need for interventions that help achieve glycemic targets early after the diagnosis of gestational diabetes.

 

Major finding: Compared with women showing rapid improvements to attain optimal glycemic control, the risk for shoulder dystocia was higher among women showing slow improvements to attain suboptimal glycemic control (adjusted relative risk [aRR] 1.41; 95% CI 1.12-1.78) and was lower among women with stably optimal glycemic control from diagnosis to delivery (aRR 0.75; 95% CI 0.61-0.92).

 

Study details: Findings are from a population-based longitudinal cohort study including 26,774 women with gestational diabetes who received prenatal care.

 

Disclosures: This study was supported by the National Institute of Diabetes and Digestive and Kidney Diseases and other sources. The authors did not declare any conflicts of interest.

 

Source: Chehab RF et al. Glycemic control trajectories and risk of perinatal complications among individuals with gestational diabetes. JAMA Netw Open. 2022;5(9):e2233955 (Sep 29). Doi: 10.1001/jamanetworkopen.2022.33955

 

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Key clinical point: Risk for shoulder dystocia was higher among women with gestational diabetes who showed a slowly improving glycemic control trajectory, highlighting the need for interventions that help achieve glycemic targets early after the diagnosis of gestational diabetes.

 

Major finding: Compared with women showing rapid improvements to attain optimal glycemic control, the risk for shoulder dystocia was higher among women showing slow improvements to attain suboptimal glycemic control (adjusted relative risk [aRR] 1.41; 95% CI 1.12-1.78) and was lower among women with stably optimal glycemic control from diagnosis to delivery (aRR 0.75; 95% CI 0.61-0.92).

 

Study details: Findings are from a population-based longitudinal cohort study including 26,774 women with gestational diabetes who received prenatal care.

 

Disclosures: This study was supported by the National Institute of Diabetes and Digestive and Kidney Diseases and other sources. The authors did not declare any conflicts of interest.

 

Source: Chehab RF et al. Glycemic control trajectories and risk of perinatal complications among individuals with gestational diabetes. JAMA Netw Open. 2022;5(9):e2233955 (Sep 29). Doi: 10.1001/jamanetworkopen.2022.33955

 

Key clinical point: Risk for shoulder dystocia was higher among women with gestational diabetes who showed a slowly improving glycemic control trajectory, highlighting the need for interventions that help achieve glycemic targets early after the diagnosis of gestational diabetes.

 

Major finding: Compared with women showing rapid improvements to attain optimal glycemic control, the risk for shoulder dystocia was higher among women showing slow improvements to attain suboptimal glycemic control (adjusted relative risk [aRR] 1.41; 95% CI 1.12-1.78) and was lower among women with stably optimal glycemic control from diagnosis to delivery (aRR 0.75; 95% CI 0.61-0.92).

 

Study details: Findings are from a population-based longitudinal cohort study including 26,774 women with gestational diabetes who received prenatal care.

 

Disclosures: This study was supported by the National Institute of Diabetes and Digestive and Kidney Diseases and other sources. The authors did not declare any conflicts of interest.

 

Source: Chehab RF et al. Glycemic control trajectories and risk of perinatal complications among individuals with gestational diabetes. JAMA Netw Open. 2022;5(9):e2233955 (Sep 29). Doi: 10.1001/jamanetworkopen.2022.33955

 

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Reduction in preterm birth justifies continued use of aspirin prophylaxis in women with chronic hypertension

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Key clinical point: Use of low-dose aspirin significantly reduced preterm birth rates but had no significant effect on the risk for preeclampsia in pregnant women with chronic hypertension.

 

Major finding: In women with chronic hypertension, the use of low-dose aspirin vs placebo during pregnancy was associated with a significant reduction in preterm birth rates (22.2% vs 31.1%; odds ratio, 0.63; 95% CI 0.45-0.89) but a nonsignificant reduction in the risk for superimposed or preterm preeclampsia.

 

Study details: Findings are from a systematic review and meta-analysis of nine studies (retrospective cohort studies and randomized controlled trials) including 2150 women with chronic hypertension who received low-dose aspirin or placebo during pregnancy.

 

Disclosures: This study did not receive any specific funding. V Giorgione’s PhD was supported by a Marie Skłodowska-Curie grant unrelated to this study. The authors declared no conflicts of interest.

 

Source: Richards EMF et al. Low-dose aspirin for the prevention of superimposed pre-eclampsia in women with chronic hypertension: A systematic review and meta-analysis. Am J Obstet Gynecol. 2022 (Oct 6). Doi: 10.1016/j.ajog.2022.09.046

 

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Key clinical point: Use of low-dose aspirin significantly reduced preterm birth rates but had no significant effect on the risk for preeclampsia in pregnant women with chronic hypertension.

 

Major finding: In women with chronic hypertension, the use of low-dose aspirin vs placebo during pregnancy was associated with a significant reduction in preterm birth rates (22.2% vs 31.1%; odds ratio, 0.63; 95% CI 0.45-0.89) but a nonsignificant reduction in the risk for superimposed or preterm preeclampsia.

 

Study details: Findings are from a systematic review and meta-analysis of nine studies (retrospective cohort studies and randomized controlled trials) including 2150 women with chronic hypertension who received low-dose aspirin or placebo during pregnancy.

 

Disclosures: This study did not receive any specific funding. V Giorgione’s PhD was supported by a Marie Skłodowska-Curie grant unrelated to this study. The authors declared no conflicts of interest.

 

Source: Richards EMF et al. Low-dose aspirin for the prevention of superimposed pre-eclampsia in women with chronic hypertension: A systematic review and meta-analysis. Am J Obstet Gynecol. 2022 (Oct 6). Doi: 10.1016/j.ajog.2022.09.046

 

Key clinical point: Use of low-dose aspirin significantly reduced preterm birth rates but had no significant effect on the risk for preeclampsia in pregnant women with chronic hypertension.

 

Major finding: In women with chronic hypertension, the use of low-dose aspirin vs placebo during pregnancy was associated with a significant reduction in preterm birth rates (22.2% vs 31.1%; odds ratio, 0.63; 95% CI 0.45-0.89) but a nonsignificant reduction in the risk for superimposed or preterm preeclampsia.

 

Study details: Findings are from a systematic review and meta-analysis of nine studies (retrospective cohort studies and randomized controlled trials) including 2150 women with chronic hypertension who received low-dose aspirin or placebo during pregnancy.

 

Disclosures: This study did not receive any specific funding. V Giorgione’s PhD was supported by a Marie Skłodowska-Curie grant unrelated to this study. The authors declared no conflicts of interest.

 

Source: Richards EMF et al. Low-dose aspirin for the prevention of superimposed pre-eclampsia in women with chronic hypertension: A systematic review and meta-analysis. Am J Obstet Gynecol. 2022 (Oct 6). Doi: 10.1016/j.ajog.2022.09.046

 

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Breath test could guide IBS-D diagnosis and use of rifaximin

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Key clinical point: Gut microbial composition differed among patients with diarrhea-predominant irritable bowel syndrome (IBS-D) who were positive vs negative for breath test (IBS-BT+ vs IBS-BT), with patients who were IBS-BT+ responding better to rifaximin therapy.

 

Major finding: Beta-diversity differed significantly among patients with IBS-BT+, those with IBS-BT, and non-IBS healthy controls (P = .005). The IBS Symptom Severity Scores (SSS), Gastrointestinal Symptom Rating Scale scores, and Bristol Stool Form Scale scores decreased significantly after rifaximin treatment in the IBS-BT+ group (all P < .05); however, only IBS-SSS scores decreased significantly in the IBS-BT group (P = .001).

 

Study details: The data come from a clinical trial including 176 participants, of which 49 were BT healthy controls and 127 were patients with IBS-D who were evaluated before and after rifaximin therapy.

 

Disclosures: This study was supported by the National Natural Science Foundation of China and the Michigan Medicine-PKUHSC Joint Institute for Translational and Clinical Research. The authors declared no conflicts of interest.

 

Source: Liu Z et al. Patients with breath test positive are necessary to be identified from irritable bowel syndrome: A clinical trial based on microbiomics and rifaximin sensitivity. Chin Med J (Engl). 2022;135(14):1716-1727 (Aug 25). Doi: 10.1097/CM9.0000000000002294

 

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Key clinical point: Gut microbial composition differed among patients with diarrhea-predominant irritable bowel syndrome (IBS-D) who were positive vs negative for breath test (IBS-BT+ vs IBS-BT), with patients who were IBS-BT+ responding better to rifaximin therapy.

 

Major finding: Beta-diversity differed significantly among patients with IBS-BT+, those with IBS-BT, and non-IBS healthy controls (P = .005). The IBS Symptom Severity Scores (SSS), Gastrointestinal Symptom Rating Scale scores, and Bristol Stool Form Scale scores decreased significantly after rifaximin treatment in the IBS-BT+ group (all P < .05); however, only IBS-SSS scores decreased significantly in the IBS-BT group (P = .001).

 

Study details: The data come from a clinical trial including 176 participants, of which 49 were BT healthy controls and 127 were patients with IBS-D who were evaluated before and after rifaximin therapy.

 

Disclosures: This study was supported by the National Natural Science Foundation of China and the Michigan Medicine-PKUHSC Joint Institute for Translational and Clinical Research. The authors declared no conflicts of interest.

 

Source: Liu Z et al. Patients with breath test positive are necessary to be identified from irritable bowel syndrome: A clinical trial based on microbiomics and rifaximin sensitivity. Chin Med J (Engl). 2022;135(14):1716-1727 (Aug 25). Doi: 10.1097/CM9.0000000000002294

 

Key clinical point: Gut microbial composition differed among patients with diarrhea-predominant irritable bowel syndrome (IBS-D) who were positive vs negative for breath test (IBS-BT+ vs IBS-BT), with patients who were IBS-BT+ responding better to rifaximin therapy.

 

Major finding: Beta-diversity differed significantly among patients with IBS-BT+, those with IBS-BT, and non-IBS healthy controls (P = .005). The IBS Symptom Severity Scores (SSS), Gastrointestinal Symptom Rating Scale scores, and Bristol Stool Form Scale scores decreased significantly after rifaximin treatment in the IBS-BT+ group (all P < .05); however, only IBS-SSS scores decreased significantly in the IBS-BT group (P = .001).

 

Study details: The data come from a clinical trial including 176 participants, of which 49 were BT healthy controls and 127 were patients with IBS-D who were evaluated before and after rifaximin therapy.

 

Disclosures: This study was supported by the National Natural Science Foundation of China and the Michigan Medicine-PKUHSC Joint Institute for Translational and Clinical Research. The authors declared no conflicts of interest.

 

Source: Liu Z et al. Patients with breath test positive are necessary to be identified from irritable bowel syndrome: A clinical trial based on microbiomics and rifaximin sensitivity. Chin Med J (Engl). 2022;135(14):1716-1727 (Aug 25). Doi: 10.1097/CM9.0000000000002294

 

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IBS: Gender differences in healthcare-seeking behavior, symptoms, and prevalence

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Key clinical point: Sex and gender are critical for a better understanding of the differences in individual experiences of irritable bowel syndrome (IBS) and should be included in discussions of the disease’s etiology, presentations, and treatment strategies.

 

Major finding: Men with IBS had fewer psychiatric conditions (P = .027), fewer sleeping problems (P = .011), less chronic pain (P = .043), and fewer contacts with the healthcare system (P < .001) compared with women with IBS, with urgency to defecate being less frequent (P = .017) and stool frequency being higher (P = .034) in men with IBS.

 

Study details: The data come from a cross-sectional study including 293 patients (64 men) with IBS and 363 non-IBS controls (62 men).

 

Disclosures: This study was funded by FORSS-the Research Council of Southeast, Sweden. The authors declared no conflicts of interest.

 

Source: Bureychak T et al. Symptoms and health experience in irritable bowel syndrome with focus on men. Neurogastroenterol Motil. 2022;34(11):e14430 (Sep 8). Doi: 10.1111/nmo.14430

 

 

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Key clinical point: Sex and gender are critical for a better understanding of the differences in individual experiences of irritable bowel syndrome (IBS) and should be included in discussions of the disease’s etiology, presentations, and treatment strategies.

 

Major finding: Men with IBS had fewer psychiatric conditions (P = .027), fewer sleeping problems (P = .011), less chronic pain (P = .043), and fewer contacts with the healthcare system (P < .001) compared with women with IBS, with urgency to defecate being less frequent (P = .017) and stool frequency being higher (P = .034) in men with IBS.

 

Study details: The data come from a cross-sectional study including 293 patients (64 men) with IBS and 363 non-IBS controls (62 men).

 

Disclosures: This study was funded by FORSS-the Research Council of Southeast, Sweden. The authors declared no conflicts of interest.

 

Source: Bureychak T et al. Symptoms and health experience in irritable bowel syndrome with focus on men. Neurogastroenterol Motil. 2022;34(11):e14430 (Sep 8). Doi: 10.1111/nmo.14430

 

 

Key clinical point: Sex and gender are critical for a better understanding of the differences in individual experiences of irritable bowel syndrome (IBS) and should be included in discussions of the disease’s etiology, presentations, and treatment strategies.

 

Major finding: Men with IBS had fewer psychiatric conditions (P = .027), fewer sleeping problems (P = .011), less chronic pain (P = .043), and fewer contacts with the healthcare system (P < .001) compared with women with IBS, with urgency to defecate being less frequent (P = .017) and stool frequency being higher (P = .034) in men with IBS.

 

Study details: The data come from a cross-sectional study including 293 patients (64 men) with IBS and 363 non-IBS controls (62 men).

 

Disclosures: This study was funded by FORSS-the Research Council of Southeast, Sweden. The authors declared no conflicts of interest.

 

Source: Bureychak T et al. Symptoms and health experience in irritable bowel syndrome with focus on men. Neurogastroenterol Motil. 2022;34(11):e14430 (Sep 8). Doi: 10.1111/nmo.14430

 

 

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Distinct gut microbe profiles linked with breath gas patterns in IBS phenotypes

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Key clinical point: Breath gas patterns are linked to distinct gut microtypes in diarrhea-predominant irritable bowel syndrome (IBS-D) and constipation-predominant IBS (IBS-C).

 

Major finding: Patients with IBS-D vs IBS-C had a higher area under the curve (AUC) for hydrogen (P = .02) and hydrogen sulfide (P = .002), whereas those with IBS-C vs IBS-D had a higher AUC for methane (P = .002). Higher breath methane in IBS-C correlated with higher breath microbial diversity, whereas higher breath hydrogen and hydrogen sulfide in IBS-D correlated with lower microbial diversity and higher relative abundance of hydrogen sulfide-producing bacteria, respectively.

 

Study details: The data come from two randomized controlled trials including patients with IBS-C (n = 124) and IBS-D (n = 47).

 

Disclosures: This study was partly funded by the Monica Lester Charitable Trust; Elias, Genevieve, and Georgianna Atol Charitable Trust; and others. Some authors declared receiving research grants or serving as consultants or speakers for various sources.

 

Source: Villanueva-Millan MJ et al. Methanogens and hydrogen sulfide producing bacteria guide distinct gut microbe profiles and irritable bowel syndrome subtypes. Am J Gastroenterol. 2022 (Sep 6). Doi: 10.14309/ajg.0000000000001997

 

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Key clinical point: Breath gas patterns are linked to distinct gut microtypes in diarrhea-predominant irritable bowel syndrome (IBS-D) and constipation-predominant IBS (IBS-C).

 

Major finding: Patients with IBS-D vs IBS-C had a higher area under the curve (AUC) for hydrogen (P = .02) and hydrogen sulfide (P = .002), whereas those with IBS-C vs IBS-D had a higher AUC for methane (P = .002). Higher breath methane in IBS-C correlated with higher breath microbial diversity, whereas higher breath hydrogen and hydrogen sulfide in IBS-D correlated with lower microbial diversity and higher relative abundance of hydrogen sulfide-producing bacteria, respectively.

 

Study details: The data come from two randomized controlled trials including patients with IBS-C (n = 124) and IBS-D (n = 47).

 

Disclosures: This study was partly funded by the Monica Lester Charitable Trust; Elias, Genevieve, and Georgianna Atol Charitable Trust; and others. Some authors declared receiving research grants or serving as consultants or speakers for various sources.

 

Source: Villanueva-Millan MJ et al. Methanogens and hydrogen sulfide producing bacteria guide distinct gut microbe profiles and irritable bowel syndrome subtypes. Am J Gastroenterol. 2022 (Sep 6). Doi: 10.14309/ajg.0000000000001997

 

Key clinical point: Breath gas patterns are linked to distinct gut microtypes in diarrhea-predominant irritable bowel syndrome (IBS-D) and constipation-predominant IBS (IBS-C).

 

Major finding: Patients with IBS-D vs IBS-C had a higher area under the curve (AUC) for hydrogen (P = .02) and hydrogen sulfide (P = .002), whereas those with IBS-C vs IBS-D had a higher AUC for methane (P = .002). Higher breath methane in IBS-C correlated with higher breath microbial diversity, whereas higher breath hydrogen and hydrogen sulfide in IBS-D correlated with lower microbial diversity and higher relative abundance of hydrogen sulfide-producing bacteria, respectively.

 

Study details: The data come from two randomized controlled trials including patients with IBS-C (n = 124) and IBS-D (n = 47).

 

Disclosures: This study was partly funded by the Monica Lester Charitable Trust; Elias, Genevieve, and Georgianna Atol Charitable Trust; and others. Some authors declared receiving research grants or serving as consultants or speakers for various sources.

 

Source: Villanueva-Millan MJ et al. Methanogens and hydrogen sulfide producing bacteria guide distinct gut microbe profiles and irritable bowel syndrome subtypes. Am J Gastroenterol. 2022 (Sep 6). Doi: 10.14309/ajg.0000000000001997

 

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Meta-analysis evaluates efficacy of FMT in IBS

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Key clinical point: Fecal microbiota transfer (FMT) did not appear to be an effective treatment for irritable bowel syndrome (IBS) symptoms whether administered orally or via colonoscopy, gastroscopy, or a nasojejunal tube, with initial improvements wearing off drastically over time.

 

Major finding: Despite a significant improvement in the quality-of-life score in the FMT vs control group (mean difference 9.32; P = .0005), the overall change in IBS symptom severity score (P = .67) and the number of respondents considering all routes of administration (P = .19) were not significantly different between treatment arms.

 

Study details: Findings are from a meta-analysis of eight randomized controlled trials including 472 patients with IBS who received either FMT or autologous transfer/placebo (control group).

 

Disclosures: This study did not declare any source of funding. The authors declared no conflicts of interest.

 

Source: Abdelghafar YA et al. Efficacy and safety of fecal microbiota transplant in irritable bowel syndrome: An update based on meta‐analysis of randomized control trials. Health Sci Rep. 2022;5(5):e814 (Sep 12). Doi: 10.1002/hsr2.814

 

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Key clinical point: Fecal microbiota transfer (FMT) did not appear to be an effective treatment for irritable bowel syndrome (IBS) symptoms whether administered orally or via colonoscopy, gastroscopy, or a nasojejunal tube, with initial improvements wearing off drastically over time.

 

Major finding: Despite a significant improvement in the quality-of-life score in the FMT vs control group (mean difference 9.32; P = .0005), the overall change in IBS symptom severity score (P = .67) and the number of respondents considering all routes of administration (P = .19) were not significantly different between treatment arms.

 

Study details: Findings are from a meta-analysis of eight randomized controlled trials including 472 patients with IBS who received either FMT or autologous transfer/placebo (control group).

 

Disclosures: This study did not declare any source of funding. The authors declared no conflicts of interest.

 

Source: Abdelghafar YA et al. Efficacy and safety of fecal microbiota transplant in irritable bowel syndrome: An update based on meta‐analysis of randomized control trials. Health Sci Rep. 2022;5(5):e814 (Sep 12). Doi: 10.1002/hsr2.814

 

Key clinical point: Fecal microbiota transfer (FMT) did not appear to be an effective treatment for irritable bowel syndrome (IBS) symptoms whether administered orally or via colonoscopy, gastroscopy, or a nasojejunal tube, with initial improvements wearing off drastically over time.

 

Major finding: Despite a significant improvement in the quality-of-life score in the FMT vs control group (mean difference 9.32; P = .0005), the overall change in IBS symptom severity score (P = .67) and the number of respondents considering all routes of administration (P = .19) were not significantly different between treatment arms.

 

Study details: Findings are from a meta-analysis of eight randomized controlled trials including 472 patients with IBS who received either FMT or autologous transfer/placebo (control group).

 

Disclosures: This study did not declare any source of funding. The authors declared no conflicts of interest.

 

Source: Abdelghafar YA et al. Efficacy and safety of fecal microbiota transplant in irritable bowel syndrome: An update based on meta‐analysis of randomized control trials. Health Sci Rep. 2022;5(5):e814 (Sep 12). Doi: 10.1002/hsr2.814

 

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Disgust sensitivity and IBS: Is there a link?

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Key clinical point: Disgust sensitivity may act as a potential trigger or predisposition factor for irritable bowel syndrome (IBS), particularly in women.

 

Major finding: Disgust sensitivity was positively correlated with IBS (correlation coefficient [r] 0.251; P = .014), with the correlation being significant in women (P = .021) but not in men (P = .505). No correlation was observed between IBS and disgust propensity (P = .911) or total disgust score (P = .115).

 

Study details: This study included 105 healthy participants who completed the Disgust Propensity and Sensitivity Scale-Revised, IBS-Quality of Life Measure, and Chronic Urticaria-Quality of Life Measure questionnaires.

 

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

 

Source: Formica S et al. Relationship between sensitivity to disgust and irritable bowel syndrome: A study on healthy individuals. Clin Neuropsychiatry. 2022;19(4):230-235 (Aug). Doi: 10.36131/cnfioritieditore20220405

 

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Key clinical point: Disgust sensitivity may act as a potential trigger or predisposition factor for irritable bowel syndrome (IBS), particularly in women.

 

Major finding: Disgust sensitivity was positively correlated with IBS (correlation coefficient [r] 0.251; P = .014), with the correlation being significant in women (P = .021) but not in men (P = .505). No correlation was observed between IBS and disgust propensity (P = .911) or total disgust score (P = .115).

 

Study details: This study included 105 healthy participants who completed the Disgust Propensity and Sensitivity Scale-Revised, IBS-Quality of Life Measure, and Chronic Urticaria-Quality of Life Measure questionnaires.

 

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

 

Source: Formica S et al. Relationship between sensitivity to disgust and irritable bowel syndrome: A study on healthy individuals. Clin Neuropsychiatry. 2022;19(4):230-235 (Aug). Doi: 10.36131/cnfioritieditore20220405

 

Key clinical point: Disgust sensitivity may act as a potential trigger or predisposition factor for irritable bowel syndrome (IBS), particularly in women.

 

Major finding: Disgust sensitivity was positively correlated with IBS (correlation coefficient [r] 0.251; P = .014), with the correlation being significant in women (P = .021) but not in men (P = .505). No correlation was observed between IBS and disgust propensity (P = .911) or total disgust score (P = .115).

 

Study details: This study included 105 healthy participants who completed the Disgust Propensity and Sensitivity Scale-Revised, IBS-Quality of Life Measure, and Chronic Urticaria-Quality of Life Measure questionnaires.

 

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

 

Source: Formica S et al. Relationship between sensitivity to disgust and irritable bowel syndrome: A study on healthy individuals. Clin Neuropsychiatry. 2022;19(4):230-235 (Aug). Doi: 10.36131/cnfioritieditore20220405

 

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Comparative analysis of acupuncture vs antispasmodics for management of IBS

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Key clinical point: Cimetropium, drotaverine, and acupuncture were more effective in improving abdominal pain than placebo in patients with irritable bowel syndrome (IBS), with acupuncture being more effective than pinaverium in relieving global IBS symptoms and causing fewer adverse events than other antispasmodics.

 

Major finding: Cimetropium (standardized mean difference [SMD] −3.00; 95% CI −4.47 to −1.53) was the most effective for relieving abdominal pain, with drotaverine, acupuncture, and pinaverium being superior to placebo. Acupuncture vs pinaverium more effectively relieved global IBS symptoms (SMD −1.11; 95% CI −1.94 to −0.28). The adverse event rate was lower with acupuncture vs most antispasmodics.

 

Study details: The data come from an adjusted indirect treatment comparison meta-analysis of 35 randomized control trials including 5190 participants.

 

Disclosures: This study was supported by the National Key Research and Development Program of the Ministry of Science and Technology of the People’s Republic of China and others. The authors declared no conflicts of interest.

 

Source: Shi YZ et al. Acupuncture vs antispasmodics in the treatment of irritable bowel syndrome: An adjusted indirect treatment comparison meta-analysis. Front Physiol. 2022; 13:1001978 (Oct 6). Doi: 10.3389/fphys.2022.1001978

 

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Key clinical point: Cimetropium, drotaverine, and acupuncture were more effective in improving abdominal pain than placebo in patients with irritable bowel syndrome (IBS), with acupuncture being more effective than pinaverium in relieving global IBS symptoms and causing fewer adverse events than other antispasmodics.

 

Major finding: Cimetropium (standardized mean difference [SMD] −3.00; 95% CI −4.47 to −1.53) was the most effective for relieving abdominal pain, with drotaverine, acupuncture, and pinaverium being superior to placebo. Acupuncture vs pinaverium more effectively relieved global IBS symptoms (SMD −1.11; 95% CI −1.94 to −0.28). The adverse event rate was lower with acupuncture vs most antispasmodics.

 

Study details: The data come from an adjusted indirect treatment comparison meta-analysis of 35 randomized control trials including 5190 participants.

 

Disclosures: This study was supported by the National Key Research and Development Program of the Ministry of Science and Technology of the People’s Republic of China and others. The authors declared no conflicts of interest.

 

Source: Shi YZ et al. Acupuncture vs antispasmodics in the treatment of irritable bowel syndrome: An adjusted indirect treatment comparison meta-analysis. Front Physiol. 2022; 13:1001978 (Oct 6). Doi: 10.3389/fphys.2022.1001978

 

Key clinical point: Cimetropium, drotaverine, and acupuncture were more effective in improving abdominal pain than placebo in patients with irritable bowel syndrome (IBS), with acupuncture being more effective than pinaverium in relieving global IBS symptoms and causing fewer adverse events than other antispasmodics.

 

Major finding: Cimetropium (standardized mean difference [SMD] −3.00; 95% CI −4.47 to −1.53) was the most effective for relieving abdominal pain, with drotaverine, acupuncture, and pinaverium being superior to placebo. Acupuncture vs pinaverium more effectively relieved global IBS symptoms (SMD −1.11; 95% CI −1.94 to −0.28). The adverse event rate was lower with acupuncture vs most antispasmodics.

 

Study details: The data come from an adjusted indirect treatment comparison meta-analysis of 35 randomized control trials including 5190 participants.

 

Disclosures: This study was supported by the National Key Research and Development Program of the Ministry of Science and Technology of the People’s Republic of China and others. The authors declared no conflicts of interest.

 

Source: Shi YZ et al. Acupuncture vs antispasmodics in the treatment of irritable bowel syndrome: An adjusted indirect treatment comparison meta-analysis. Front Physiol. 2022; 13:1001978 (Oct 6). Doi: 10.3389/fphys.2022.1001978

 

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Effect of ACHIM suspension vs donor-FMT on gut microbiota and IBS symptoms

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Mon, 10/31/2022 - 16:08

Key clinical point: Treatment with anaerobically cultivated human intestinal microbiota (ACHIM) suspension or donor fecal microbiota transplantation (donor-FMT) but not placebo changed gut microbiota profiles in patients with irritable bowel syndrome (IBS) to those measured in healthy control individuals along with significant changes in bacterial strain signal.

 

Major finding: Patients receiving donor-FMT vs placebo had more significant bacterial strain signals for Actinobacteria spp. and Bifidobacteria spp., whereas those receiving ACHIM or donor-FMT vs placebo had more significant signals for Alistipes onderdonkii (all P < .05). After receiving ACHIM suspension or donor-FMT, but not placebo, the bacterial signal in patients resembled more that in healthy controls. No post-transplant complications were reported.

 

Study details: The data come from a randomized controlled study including 43 patients with IBS-D who received ACHIM suspension (n = 17), donor-FMT (n = 11), or placebo (patient’s own feces; n = 15).

 

Disclosures: This study was funded by Helse Vest, Norway. The authors declared no conflicts of interest.

 

Source: Mazzawi T et al. The effect of anaerobically cultivated human intestinal microbiota compared to fecal microbiota transplantation on gut microbiota profile and symptoms of irritable bowel syndrome, a double-blind placebo-controlled study. Microorganisms. 2022;10(9):1819 (Sep 11). Doi: 10.3390/microorganisms10091819

 

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Key clinical point: Treatment with anaerobically cultivated human intestinal microbiota (ACHIM) suspension or donor fecal microbiota transplantation (donor-FMT) but not placebo changed gut microbiota profiles in patients with irritable bowel syndrome (IBS) to those measured in healthy control individuals along with significant changes in bacterial strain signal.

 

Major finding: Patients receiving donor-FMT vs placebo had more significant bacterial strain signals for Actinobacteria spp. and Bifidobacteria spp., whereas those receiving ACHIM or donor-FMT vs placebo had more significant signals for Alistipes onderdonkii (all P < .05). After receiving ACHIM suspension or donor-FMT, but not placebo, the bacterial signal in patients resembled more that in healthy controls. No post-transplant complications were reported.

 

Study details: The data come from a randomized controlled study including 43 patients with IBS-D who received ACHIM suspension (n = 17), donor-FMT (n = 11), or placebo (patient’s own feces; n = 15).

 

Disclosures: This study was funded by Helse Vest, Norway. The authors declared no conflicts of interest.

 

Source: Mazzawi T et al. The effect of anaerobically cultivated human intestinal microbiota compared to fecal microbiota transplantation on gut microbiota profile and symptoms of irritable bowel syndrome, a double-blind placebo-controlled study. Microorganisms. 2022;10(9):1819 (Sep 11). Doi: 10.3390/microorganisms10091819

 

Key clinical point: Treatment with anaerobically cultivated human intestinal microbiota (ACHIM) suspension or donor fecal microbiota transplantation (donor-FMT) but not placebo changed gut microbiota profiles in patients with irritable bowel syndrome (IBS) to those measured in healthy control individuals along with significant changes in bacterial strain signal.

 

Major finding: Patients receiving donor-FMT vs placebo had more significant bacterial strain signals for Actinobacteria spp. and Bifidobacteria spp., whereas those receiving ACHIM or donor-FMT vs placebo had more significant signals for Alistipes onderdonkii (all P < .05). After receiving ACHIM suspension or donor-FMT, but not placebo, the bacterial signal in patients resembled more that in healthy controls. No post-transplant complications were reported.

 

Study details: The data come from a randomized controlled study including 43 patients with IBS-D who received ACHIM suspension (n = 17), donor-FMT (n = 11), or placebo (patient’s own feces; n = 15).

 

Disclosures: This study was funded by Helse Vest, Norway. The authors declared no conflicts of interest.

 

Source: Mazzawi T et al. The effect of anaerobically cultivated human intestinal microbiota compared to fecal microbiota transplantation on gut microbiota profile and symptoms of irritable bowel syndrome, a double-blind placebo-controlled study. Microorganisms. 2022;10(9):1819 (Sep 11). Doi: 10.3390/microorganisms10091819

 

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Concordance between subjective (BSFS) and objective (stool water content) reporting in IBS

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Key clinical point: Modest conformation exists between subjective reporting of the Bristol Stool Form Scale (BSFS) and fecal consistency measured by stool water content in irritable bowel syndrome (IBS), warranting caution when using BSFS reporting for subtyping IBS.

 

Major finding: BSFS scores significantly correlated with stool water content (correlation coefficient [r] 0.36, P < .0001); however, 77% of stool samples referred as BSFS 1-2 had a water content of ≤68.5% and 52.0% of samples referred as BSFS 6-7 had a water content of ≥78%. Sensitivity and specificity for BSFS 1-2 were 32% and 94%, respectively, and those for BSFS 6-7 were 37% and 93%, respectively.

 

Study details: The data come from a subanalysis of a previous randomized three-way crossover trial including 110 participants with severe-to-moderate IBS who underwent 1-week provocation with fermentable oligosaccharides, disaccharides, monosaccharides, and polyols; gluten; or placebo.

 

Disclosures: This study was funded by Formas and the Swedish Research Council. The authors declared no conflicts of interest.

 

Source: Nordin E et al. Modest conformity between self-reporting of Bristol stool form and fecal consistency measured by stool water content in irritable bowel syndrome, a FODMAP and gluten trial. Am J Gastroenterol. 2022;117(10):1668-1674 (Aug 12). Doi: 10.14309/ajg.0000000000001942

 

 

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Key clinical point: Modest conformation exists between subjective reporting of the Bristol Stool Form Scale (BSFS) and fecal consistency measured by stool water content in irritable bowel syndrome (IBS), warranting caution when using BSFS reporting for subtyping IBS.

 

Major finding: BSFS scores significantly correlated with stool water content (correlation coefficient [r] 0.36, P < .0001); however, 77% of stool samples referred as BSFS 1-2 had a water content of ≤68.5% and 52.0% of samples referred as BSFS 6-7 had a water content of ≥78%. Sensitivity and specificity for BSFS 1-2 were 32% and 94%, respectively, and those for BSFS 6-7 were 37% and 93%, respectively.

 

Study details: The data come from a subanalysis of a previous randomized three-way crossover trial including 110 participants with severe-to-moderate IBS who underwent 1-week provocation with fermentable oligosaccharides, disaccharides, monosaccharides, and polyols; gluten; or placebo.

 

Disclosures: This study was funded by Formas and the Swedish Research Council. The authors declared no conflicts of interest.

 

Source: Nordin E et al. Modest conformity between self-reporting of Bristol stool form and fecal consistency measured by stool water content in irritable bowel syndrome, a FODMAP and gluten trial. Am J Gastroenterol. 2022;117(10):1668-1674 (Aug 12). Doi: 10.14309/ajg.0000000000001942

 

 

Key clinical point: Modest conformation exists between subjective reporting of the Bristol Stool Form Scale (BSFS) and fecal consistency measured by stool water content in irritable bowel syndrome (IBS), warranting caution when using BSFS reporting for subtyping IBS.

 

Major finding: BSFS scores significantly correlated with stool water content (correlation coefficient [r] 0.36, P < .0001); however, 77% of stool samples referred as BSFS 1-2 had a water content of ≤68.5% and 52.0% of samples referred as BSFS 6-7 had a water content of ≥78%. Sensitivity and specificity for BSFS 1-2 were 32% and 94%, respectively, and those for BSFS 6-7 were 37% and 93%, respectively.

 

Study details: The data come from a subanalysis of a previous randomized three-way crossover trial including 110 participants with severe-to-moderate IBS who underwent 1-week provocation with fermentable oligosaccharides, disaccharides, monosaccharides, and polyols; gluten; or placebo.

 

Disclosures: This study was funded by Formas and the Swedish Research Council. The authors declared no conflicts of interest.

 

Source: Nordin E et al. Modest conformity between self-reporting of Bristol stool form and fecal consistency measured by stool water content in irritable bowel syndrome, a FODMAP and gluten trial. Am J Gastroenterol. 2022;117(10):1668-1674 (Aug 12). Doi: 10.14309/ajg.0000000000001942

 

 

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