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Gastrointestinal Tolerance of D-Allulose in Healthy and Young Adults. A Non-Randomized Controlled Trial.
Han, Y, Choi, BR, Kim, SY, Kim, SB, Kim, YH, Kwon, EY, Choi, MS
Nutrients. 2018;(12)
Abstract
D-allulose has recently received attention as a sugar substitute. However, there are currently no reports regarding its association with gastrointestinal (GI) tolerance. Thus, we performed a GI tolerance test for D-allulose in order to establish its daily acceptable intake level. When the dose of D-allulose was gradually increased in steps of 0.1 g/kg·Body Weight (BW) to identify the maximum single dose for occasional ingestion, no cases of severe diarrhea or GI symptoms were noted until a dose of 0.4 g/kg·BW was reached. Severe symptoms of diarrhea were noted at a dose of 0.5 g/kg·BW. Similarly, the GI tolerance test did not show any incidences of severe diarrhea or GI symptoms until a dose of 0.5 g/kg·BW was reached. A correlation analysis of the GI tolerance test for D-allulose and sugar revealed significantly higher frequencies of symptoms of diarrhea (p = 0.004), abdominal distention (p = 0.039), and abdominal pain (p = 0.031) after D-allulose intake. Increasing the total daily D-allulose intake gradually to 1.0 g/kg·BW for regular ingestion resulted in incidences of severe nausea, abdominal pain, headache, anorexia, and diarrheal symptoms. Based on these results, we suggest a maximum single dose and maximum total daily intake of D-Allulose of 0.4 g/kg·BW and 0.9 g/kg·BW, respectively.
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2.
Irritable bowel syndrome symptom severity improves equally with probiotic and placebo.
Lyra, A, Hillilä, M, Huttunen, T, Männikkö, S, Taalikka, M, Tennilä, J, Tarpila, A, Lahtinen, S, Ouwehand, AC, Veijola, L
World journal of gastroenterology. 2016;(48):10631-10642
Abstract
AIM: To determine the effects of Lactobacillus acidophilus NCFM on irritable bowel syndrome (IBS) symptoms and quality of life (QoL). METHODS In this randomized triple-blind trial, adult IBS volunteers who were recruited according to Rome III criteria received 109 or 1010 colony-forming units of NCFM or placebo daily for 12 wk. IBS Symptom Severity Score (IBS-SSS), which constituted the primary outcome, and secondary outcomes, including individual IBS symptoms, IBS-related QoL questionnaire, anxiety and depression, defecation frequency, and stool consistency, were assessed at baseline at the end of the 8-wk run-in period, after 4 and 12 wk of intervention, and after a 4-wk washout. RESULTS A total of 340 of 391 randomized volunteers completed the trial. IBS-SSS improved over 12 wk of treatment in all treatment groups, decreasing by a mean ± SD of 44.0 ± 80.2, 50.8 ± 82.4, and 48.3 ± 72.2 in the placebo, active low-dose, and active high-dose groups, respectively. Similarly, secondary outcomes did not differ between treatment groups. However, in a post hoc analysis of volunteers with moderate to severe abdominal pain at baseline (VAS > 35/100), the treatment significantly reduced the sensation of abdominal pain. Pain scores fell by 20.8 ± 22.8, 29.4 ± 17.9, and 31.2 ± 21.9 in the placebo, active low-dose, and active high-dose groups, respectively (P value for placebo vs combined active doses = 0.0460). CONCLUSION NCFM alleviates moderate to severe abdominal pain, consistent with earlier observations of this strain mitigating visceral pain through increased analgesic receptor expression.
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3.
A pilot study of S-adenosylmethionine in treatment of functional abdominal pain in children.
Choi, LJ, Huang, JS
Alternative therapies in health and medicine. 2013;(5):61-4
Abstract
CONTEXT Functional abdominal pain (FAP) is one of the most common functional gastrointestinal disorders (FGIDs) in children. Currently, medical practitioners widely use tricyclic antidepressants to treat FAP. Those antidepressants, however, have been associated with an increased risk of suicidal ideation, and the accompanying side effects often limit the benefits. S-adenosylmethionine (SAM-e) is a dietary supplement that has efficacy as an antidepressant and as a treatment for chronic pain. OBJECTIVE The research team hypothesized that during SAM-e exposure (1) participants' pain reports would significantly improve over time, (2) participants' reported quality of life would significantly improve over time, and (3) toxicity measures (liver-function tests and mania and depression scales) would not change significantly. DESIGN The research team performed an open-label, doseescalation trial of oral SAM-e among children with FAP. Participants came to the research facility for measurements at baseline and after 2 wk, 1 mo, and 2 mo. The research team monitored participants for potential toxicities (liver toxicity, mania, and depression) throughout the trial. SETTING The trial was conducted at the University of California, San Diego. PARTICIPANTS The research team recruited children and adolescents with FAP via advertisement at several community general pediatric clinics and at the research team's subspecialty pediatric gastrointestinal clinic at a tertiary care center. The eight resulting participants were children with a median and mean age of 14 y. INTERVENTION To treat persistent abdominal pain, all participants received SAM-e at an initial dose of 200 mg/d, with escalation to a maximum dose of 1400 mg/d over the period of 2 mo. OUTCOME MEASURES The primary outcomes were the participants' self-reports of pain and quality of life. The research team used the multidimensional measure for recurrent abdominal pain (MM-RAP), Wong-Baker FACES Pain Rating Scale, and the PedsQL for those measurements. The team used repeated measures analyses to analyze the data. RESULTS Six participants completed the study. The research team demonstrated an improvement in self-pain reports over the 2-mo follow-up period (P = .004). The median dose of SAM-e that participants took at the 2-mo follow-up period was 1400 mg (interquartile range: 950-1400 mg) daily. Liver function tests and assessments for mania and depression did not change over the study period. CONCLUSIONS Oral SAM-e demonstrates promise in reducing abdominal pain among children with FAP, with minimal toxicity. The research team needs to conduct larger, placebo-controlled trials to support its initial findings.
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4.
[Effect of fried bacon and parsley sauce on gastrointestinal symptoms in healthy old boys footballer].
Grønbæk, H, Jensen, MP
Ugeskrift for laeger. 2012;(49):3074-8
Abstract
INTRODUCTION Knowledge of the importance of diet on gastrointestinal function and symptoms is generally poorly. In recent years, The New Nordic Food Culture is suggested to have favourable effects. Unfortunally there are huge waiting lists at the most popular restaurants, so we investigated the more traditional "Nordic kitchen". There are no previous studies concerning intake of fried bacon and parsley sauce (FBPS) in healthy middle-aged footballers. MATERIAL AND METHODS Non-blinded, non-randomized, crossover study with a questionnaire survey of 18 healthy old boys footballers before and after FBPS intake. Ten players responded to the questionnaire, including one who was not exposed to FBPS. RESULTS The median intake was 15 pieces of fried bacon (range 12-23), 1.5 dl parsley sauce (range 1-5 dl), and eight potatoes (range 6-30), but no dessert. We found a significantly increased stool frequency and a trend towards change in consistency compared to baseline. We found increased abdominal pain and a decrease in general well-being, but could not demonstrate any impact on complaints from the family. CONCLUSION In otherwise healthy old boys footballers the FBPS diet has great impact on a range of gastrointestinal symptoms. FBPS affected stool frequency and abdominal pain, but caused no effect on family complaints. We cannot exclude a dose-response effect or a gender/age phenomenon; and we suggest supplemental dose-response studies and studies including women of all ages. Further, we recommend a detailed dietary assessment before referring patients with gastrointestinal symptoms for invasive procedures like colonoscopy or CT-scanning. TRIAL REGISTRATION none FUNDING none.
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Linaclotide improves abdominal pain and bowel habits in a phase IIb study of patients with irritable bowel syndrome with constipation.
Johnston, JM, Kurtz, CB, Macdougall, JE, Lavins, BJ, Currie, MG, Fitch, DA, O'Dea, C, Baird, M, Lembo, AJ
Gastroenterology. 2010;(6):1877-1886.e2
Abstract
BACKGROUND & AIMS Linaclotide, a minimally absorbed, 14-amino acid peptide agonist of guanylate cyclase-C, has shown benefit in a proof-of-concept study for the treatment of patients with irritable bowel syndrome (IBS) with constipation (IBS-C). We assessed the efficacy and safety of linaclotide at a daily dose range of 75-600 μg in IBS-C. METHODS We performed a randomized, double-blind, multicenter, placebo-controlled study of 420 patients with IBS-C given oral linaclotide at doses of 75, 150, 300, or 600 μg or placebo once daily for 12 weeks. End points included change from baseline in daily bowel habits, daily abdominal symptoms, and weekly global assessments, in addition to responder criteria. RESULTS All doses of linaclotide significantly improved bowel habits, including frequency of spontaneous bowel movements and complete spontaneous bowel movements (primary end point), severity of straining, and stool consistency. Abdominal pain was significantly reduced from baseline, compared with placebo; mean changes in abdominal pain (assessed on a 5-point scale) from baseline were -0.71, -0.71, -0.90, and -0.86 for linaclotide doses of 75, 150, 300, and 600 μg, respectively, compared with -0.49 for placebo. Likewise, most doses of linaclotide significantly improved other abdominal symptoms, including discomfort and bloating, and global measures of IBS-C compared with placebo. Effects were observed within the first week and were sustained throughout 12 weeks of treatment. Except for diarrhea, the incidence of adverse events was similar between placebo and linaclotide groups. CONCLUSIONS Linaclotide, across a wide range of doses, significantly improved symptoms of IBS-C, including abdominal pain and bowel symptoms. Diarrhea was the only dose-dependent adverse event and was usually of mild or moderate severity.
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Diagnostic value of a peroral sucrose permeability test in children with recurrent upper abdominal pain.
Pinotić, L, Zecić-Fijacko, M, Vcev, A, Paulini, D, Mihaljević, S, Horvat, D, Mandić, Z, Votava-Raić, A, Boranić, M
Collegium antropologicum. 2004;(2):775-80
Abstract
The access of ingested sucrose into blood and urine indicates the presence of mucosal lesions in the upper gastrointestinal tract. The study involved 42 children, aged 5-15, having recurrent upper abdominal pain and 43 peers with minor extra-abdominal complaints. Sucrose in urine was determined by thin layer chromatography. The test was positive in 27 out of 42 children having recurrent abdominal pain (64.3%) and in none of the control children (chi2 = 37.6, p < 0.0001). When correlated with endoscopic findings it was falsely negative in 12 out of 38 patients with endoscopically verified lesions of the stomach or duodenum and falsely positive in 1 out of 4 without lesions. Sensitivity of the test was 68.4%, specificity 97.9%, positive predictive value 96.3%. The test cannot be used as an alternative to endoscopy, but may serve for screening of candidates for it.