Browsing by Author "Camilleri, Michael"

Now showing 1 - 5 of 5
  • Thumbnail Image
    Item
    Associations of Habitual Dietary Intake With Fecal Short-Chain Fatty Acids and Bowel Functions in Irritable Bowel Syndrome
    (Wolters Kluwer, 2022) Calderon, Gerardo; Patel, Chirag; Camilleri, Michael; James-Stevenson, Toyia; Bohm, Matthew; Siwiec, Robert; Rogers, Nicholas; Wo, John; Lockett, Carolyn; Gupta, Anita; Xu, Huiping; Shin, Andrea; Medicine, School of Medicine
    Background goals: Diet may contribute to symptoms of irritable bowel syndrome (IBS) and luminal production of putative IBS biomarkers including short-chain fatty acids (SCFAs). Study aims were to to assess relationships of habitual fiber or starch intake with fecal SCFAs in patients with IBS and healthy volunteers (HVs). Study: In 18 HVs and 30 patients with IBS (13 constipation-predominant [IBS-C] and 17 diarrhea-predominant [IBS-D]), habitual diet using a food frequency questionnaire; bowel functions using a validated bowel diary; and fecal SCFAs by HPLC-mass spectrometry were assessed. Associations of fiber and starch with SCFAs were analyzed using Spearman (rs) and Pearson (R) correlations. Relationships between other dietary endpoints, SCFAs, and bowel functions were explored. Results: Habitual fiber or starch intakes were not significantly correlated with SCFAs or bowel functions in all participants or HVs nor with SCFAs in IBS. Starch was negatively correlated (R=-0.53; P=0.04) with complete evacuation in IBS-D. Fiber (rs=0.65; P=0.02) and starch (rs=0.56; P=0.05) were correlated with ease of passage in IBS-C. Stool form, frequency, and ease of passage were positively correlated with total SCFAs (all P<0.05), acetate (all P<0.01), propionate (all P<0.05), and butyrate (form P=0.01; ease of passage P=0.05) among all participants, but not in IBS. Complete evacuation was negatively correlated with propionate (R=-0.34; P=0.04) in all participants. Total (P=0.04) and individual SCFAs (all P<0.05) were positively correlated with stool form in HVs. Conclusions: Habitual fiber and starch intake does not influence fecal SCFAs but may influence bowel functions in IBS. Fecal SCFAs correlate with bowel functions among all participants including HVs.
  • Thumbnail Image
    Item
    Comparison of efficacy of pharmacological treatments for chronic idiopathic constipation: a systematic review and network meta-analysis
    (BMJ, 2017) Nelson, Alfred D.; Camilleri, Michael; Chirapongsathorn, Sakkarin; Vijayvargiya, Priya; Valentin, Nelson; Shin, Andrea; Erwin, Patricia J.; Wang, Zhen; Murad, M. Hassan; Department of Medicine, IU School of Medicine
    Objective To compare efficacy of pharmacotherapies for chronic idiopathic constipation (CIC) based on comparisons to placebo using Bayesian network meta-analysis. Data sources We conducted searches (inception to May 2015) of MEDLINE, EMBASE, Scopus and Cochrane Central, as well as original data from authors or drug companies for the medications used for CIC. Study selection Phase IIB and phase III randomised, placebo-controlled trials (RCT) of ≥4 weeks' treatment for CIC in adults with Rome II or III criteria for functional constipation; trials included at least one of four end points. Data extraction and synthesis Two investigators independently evaluated all full-text articles that met inclusion criteria and extracted data for primary and secondary end points, risk of bias and quality of evidence. Outcomes Primary end points were ≥3 complete spontaneous bowel movements (CSBM)/week and increase over baseline by ≥1 CSBM/week. Secondary end points were change from baseline (Δb) in the number of SBM/week and Δb CSBM/week. Results Twenty-one RCTs (9189 patients) met inclusion and end point criteria: 9 prucalopride, 3 lubiprostone, 3 linaclotide, 2 tegaserod, 1 each velusetrag, elobixibat, bisacodyl and sodium picosulphate (NaP). All prespecified end points were unavailable in four polyethylene glycol studies. Bisacodyl, NaP, prucalopride and velusetrag were superior to placebo for the ≥3 CSBM/week end point. No drug was superior at improving the primary end points on network meta-analysis. Bisacodyl appeared superior to the other drugs for the secondary end point, Δb in number of SBM/week. Conclusions Current drugs for CIC show similar efficacy. Bisacodyl may be superior to prescription medications for Δb in the number of SBM/week in CIC.
  • Thumbnail Image
    Item
    Effects of Irritable Bowel Syndrome on Daily Activities Vary Among Subtypes Based on Results From the IBS in America Survey
    (Elsevier, 2019-11) Ballou, Sarah; McMahon, Courtney; Lee, Ha-Neul; Katon, Jesse; Shin, Andrea; Rangan, Vikram; Singh, Prashant; Nee, Judy; Camilleri, Michael; Lembo, Anthony; Iturrino, Johanna; Medicine, School of Medicine
    Background & Aims Irritable bowel syndrome (IBS) is associated with significant disease burden and decreased quality of life (QOL). We investigated the effects of IBS on different areas of daily function and compared these among disease subtypes. Methods The Life with IBS survey was conducted by Gfk Public Affairs & Corporate Communications from September through October 2015. Respondents met Rome III criteria for constipation-predominant or diarrhea-predominant IBS (IBS-C and IBS-D, respectively). Data were collected from 3254 individuals (mean age, 47 years; 81% female; and 90% Caucasian) who met IBS criteria. Results Respondents who were employed or in school (n = 1885) reported that IBS symptoms affected their productivity an average of 8.0 days out of the month and they missed approximately 1.5 days of work/school per month because of IBS. More than half the individuals reported that their symptoms were very bothersome. Individuals with IBS-C were more likely than with IBS-D to report avoiding sex, difficulty concentrating, and feeling self-conscious. Individuals with IBS-D reported more avoidance of places without bathrooms, difficulty making plans, avoiding leaving the house, and reluctance to travel. These differences remained when controlling for symptom bothersomeness, age, sex, and employment status. In exchange for 1 month of relief from IBS, more than half of the sample reported they would be willing to give up caffeine or alcohol, 40% would give up sex, 24.5% would give up cell phones, and 21.5% would give up the internet for 1 month. Conclusions Although the perceived effects of IBS symptoms on productivity are similar among its subtypes, patients with IBS-C and IBS-D report differences in specific areas of daily function.
  • Thumbnail Image
    Item
    Fecal bile acids, fecal short-chain fatty acids, and the intestinal microbiota in patients with irritable bowel syndrome (IBS) and control volunteers
    (Cambridge University Press, 2018-06) Shin, Andrea; Nelson, David; Wo, John; Camilleri, Michael; James-Stevenson, Toyia; Siwiec, Robert; Bohm, Matthew; Gupta, Anita; Medicine, School of Medicine
    OBJECTIVES/SPECIFIC AIMS: Objectives and goals of this study will be to: (1) compare fecal microbiota and fecal organic acids in irritable bowel syndrome (IBS) patients and controls and (2) investigate the association between colonic transit and fecal microbiota in IBS patients and controls. METHODS/STUDY POPULATION: We propose an investigation of fecal organic acids, colonic transit and fecal microbiota in 36 IBS patients and 18 healthy controls. The target population will be adults ages 18–65 years meeting Rome IV criteria for IBS (both diarrhea- and constipation-predominant, IBS-D and IBS-C) and asymptomatic controls. Exclusion criteria are: (a) history of microscopic colitis, inflammatory bowel disease, celiac disease, visceral cancer, chronic infectious disease, immunodeficiency, uncontrolled thyroid disease, liver disease, or elevated AST/ALT>2.0× the upper limit of normal, (b) prior radiation therapy of the abdomen or abdominal surgeries with the exception of appendectomy or cholecystectomy >6 months before study initiation, (c) ingestion of prescription, over the counter, or herbal medications affecting gastrointestinal transit or study interpretation within 6 months of study initiation for controls or within 2 days before study initiation for IBS patients, (d) pregnant females, (e) antibiotic usage within 3 months before study participation, (f) prebiotic or probiotic usage within the 2 weeks before study initiation, (g) tobacco users. Primary outcomes will be fecal bile acid excretion and profile, short-chain fatty acid excretion and profile, colonic transit, and fecal microbiota. Secondary outcomes will be stool characteristics based on responses to validated bowel diaries. Stool samples will be collected from participants during the last 2 days of a 4-day 100 g fat diet and split into 3 samples for fecal microbiota, SCFA, and bile acid analysis and frozen. Frozen aliquots will be shipped to the Metabolite Profiling Facility at Purdue University and the Mayo Clinic Department of Laboratory Medicine and Pathology for SCFA and bile acid measurements, respectively. Analysis of fecal microbiota will be performed in the research laboratory of Dr David Nelson in collaboration with bioinformatics expertise affiliated with the Nelson lab. Colonic transit time will be measured with the previously validated method using radio-opaque markers. Generalized linear models will be used as the analysis framework for comparing study endpoints among groups. RESULTS/ANTICIPATED RESULTS: This study seeks to examine the innovative concept that specific microbial signatures are associated with increased fecal excretion of organic acids to provide unique insights on a potential mechanistic link between altered intraluminal organic acids and fecal microbiota. DISCUSSION/SIGNIFICANCE OF IMPACT: Results may lead to development of targets for novel therapies and diagnostic biomarkers for IBS, emphasizing the role of the fecal metabolome.
  • Thumbnail Image
    Item
    Information- and Health-care Seeking Behaviors in Patients With Irritable Bowel Syndrome
    (Elsevier, 2019) Shin, Andrea; Ballou, Sarah; Camilleri, Michael; Xu, Huiping; Lembo, Anthony; Medicine, School of Medicine
    Irritable bowel syndrome (IBS) is a common and clinically heterogeneous gastrointestinal disorder that can be divided into 4 subtypes: IBS with constipation (IBS-C), IBS with diarrhea (IBS-D), IBS with mixed bowel habits, and unclassified IBS. IBS decreases quality of life1 and imposes a substantial economic burden on the healthcare system.2 To develop efficient approaches to address the individual needs of IBS patients while minimizing healthcare resource overutilization, it is important to identify the factors that drive patients to seek care, to clarify the burden associated with distinct IBS subtypes, and to be aware of the resources from which IBS patients seek health-related information. We aimed to compare healthcare and information seeking between individuals with IBS-C and IBS-D. Methods Study Cohort Adults aged 18–100 years were recruited from a national sample to participate in an online consumer survey study between September 14, 2015 and October 21, 2015 to assess healthcare and information seeking. Details of the study design are described elsewhere.3 Statistical Analysis Associations of healthcare and information seeking with IBS subtype were examined by using multivariate logistic regression, negative binomial regression, and the proportional odds model where appropriate adjusting for relevant covariates (age, sex, race/ethnicity, marital status, education level, employment status, and IBS diagnosed by a doctor). Results Healthcare Seeking in Irritable Bowel Syndrome With Constipation and Irritable Bowel Syndrome With Diarrhea Among 3254 participants, 82% (N = 2674) reported speaking to at least 1 healthcare professional about their symptoms. Women with IBS-D were associated with a decreased odds ratio of seeking care from an obstetrician/gynecologist or a pharmacist than women with IBS-C. Among those who saw at least 1 healthcare professional (N = 2674), there were no significant differences in the number of healthcare professionals ever spoken to. However, IBS-D was associated with a decreased number (8% less) of healthcare professionals spoken to in the past 12 months compared with IBS-C. Comparisons of reasons for which participants waited to seek care revealed that IBS-C participants (16.3%) reported that other health conditions took priority more frequently than IBS-D participants (8.0%). Results are summarized in Table 1.