November 4th, 2015; By: Adam Leitenberger
“Based on the prior literature, chronic constipation has not been well characterized as a risk factor for the development of [colorectal cancer] or other serious organic disorders,” Lauren B. Gerson, MD, FACG, from the California Pacific Medical Center, said during her presentation. “The purpose of this study was to use a very large retrospective database and try to determine whether chronic constipation was in fact associated with a future diagnosis of a serious GI event, which would include any type of GI malignancy, colorectal cancer, ischemic colitis, diverticulitis or inflammatory bowel disease.”
Gerson and colleagues identified and matched patients aged 50 years or younger with and without chronic constipation (each group, n = 12,838) using a large electronic health record database, and estimated hazard ratios for the above mentioned GI events.
“Chronic constipation disorders may be risk factors for serious outcomes, even in younger patients, and as far as we know this might be novel — there hasn’t been prior literature demonstrating [this] in younger patients,” Gerson concluded. “The magnitude of this risk that we demonstrated was highest for CRC and diverticulitis, and lowest for IBD. There was a threefold increased risk for development of at least one of the pre-specified outcomes, and even in younger patients, clinicians may want to very carefully assess bowel habits, which may [help] diagnose more of these cases.
According to a recent systematic review, elimination diets cannot be strongly recommended to patients with irritable bowel syndrome until further evidence becomes available.
Because efficacy data from randomized controlled trials of dietary interventions in patients with IBS had not been systematically evaluated, Paul Moayyedi, MBChB, PhD, MPH, FACG, from McMaster University in Ontario, Canada, and colleagues, identified 17 randomized controlled trials of elimination diets involving 1,568 IBS patients published up to December 2013.
Three RCTs involving 230 patients met eligibility criteria, but each assessed different interventions, so a meta-analysis was not performed. The primary outcome of interest was global improvement in IBS symptoms or improvement in abdominal pain if global symptoms were not reported.
Researchers performed a randomized, double-blind crossover trial of children aged 7 to 17 years with Rome III-defined IBS recruited from September 2011 to December 2013 to evaluate the efficacy of low fermentable oligosaccharides, disaccharides, monosaccharides and polylols (FODMAP) diet in pediatric IBS, and to determine if gut microbial composition or metabolic capacity are associated with response to the diet.
Thirty-three patients (67% female; mean age, 11.5 ± 3 years) completed a 1-week baseline period during which they adhered to their habitual diet. Then they were randomly assigned to receive a low FODMAP diet or typical American diet for 2 days, returned to their habitual diet for a 5-day washout period, and then crossed over to the other intervention diet for 2 days. Stool samples were collected at baseline to determine gut microbial composition and metabolic capacity, breath samples were collected on the second day of each dietary intervention for gas production analyses, and number of abdominal pain episodes were reported through a Pain and Stool Diary.
Fewer abdominal pain episodes per day occurred during low FODMAP (mean, 1.1 ± 0.2) compared with typical American diet (mean, 1.7 ± 0.4; P < .05), and compared with baseline (mean, 1.4 ± 0.2), fewer abdominal pain episodes per day occurred during low FODMAP diet while more episodes occurred during the typical American diet (both P < .01).
August 27th, 2015
The gastrointestinal (G.I.) tract is composed of smooth muscle, which differs from skeletal muscle. Skeletal muscle, like your biceps or thigh muscles, is under voluntary control. Nerve impulses generated in the brain tell these muscles what to do, and without the brain’s directions, they can’t do anything. Smooth muscle, on the other hand, doesn’t need the brain to tell it to contract, it contracts on its own. It also operates with wave-like contractions that are perfectly suited for the G.I. tract because they help move digested material along.
Most muscular function declines with age, and so it is with the smooth muscle of the G.I. tract. This results in a slowdown in the G.I. pipeline, which allows more water to be absorbed from the digested material. In turn, with less water content, it becomes more compacted and hard.
Does this necessarily mean constipation? No. If aging G.I. muscles were the only challenge you faced, it’s likely that the slowdown caused by less active muscles, in and of itself, would not cause constipation. This means other factors contribute, and the cumulative effects result in constipation...
For more go to: The Courier Journal