Fructose malabsorption may trigger gastrointestinal symptoms in irritable bowel syndrome patients and a low fructose diet seems to improve digestive symptoms.
The aim of our study was to determine ...whether fructose malabsorption detected by a 25g fructose breath test could be a predictor of the efficacy of a low fructose diet.
88 patients (73 women, median age, 45.5 years, range 18–69) with irritable bowel syndrome according to Rome III criteria were included in this prospective, controlled study. All 88 patients had a 25 g fructose breath test; 37 had a positive test result defining fructose malabsorption. All 88 patients followed a low fructose diet for 2 weeks, blinded to their test results. Patients filled self validated-questionnaires before and at the end of the dietary period. The main outcome measurement was the Irritable Bowel Syndrome-Symptom Severity Score.
Irritable Bowel Syndrome-Symptom Severity Score significantly decreased in fructose absorbers and fructose malabsorbers after a low fructose diet (−68.0 −137; 0 versus −73.5 −173; −11.5) with no difference according to fructose breath test result (adjusted P = 0.984).
A positive 25 g fructose breath test is not a predictor of the efficacy of a low fructose diet in irritable bowel syndrome.
www.clinicaltrials.gov (NCT02188680).
Background
Functional dyspepsia and bladder pain syndrome are well‐known to overlap with irritable bowel syndrome. Whether functional dyspepsia overlaps with bladder pain syndrome remains unknown. ...Our aim was to evaluate the presence of bladder pain syndrome in functional dyspepsia patients and its impact.
Methods
All consecutive patients with investigated dyspeptic symptoms in our tertiary care center between March 2015 and November 2018 were studied. Functional dyspepsia and irritable bowel syndrome were diagnosed according to Rome III and IV criteria while bladder pain syndrome was diagnosed using ESSIC criteria. Validated questionnaires were filled to assess quality of life (GIQLI), anxiety and depression (HADS), sleep (PSQI), and insomnia (ISI). Dyspeptic symptoms severity was assessed individually for eight dyspeptic complaints.
Key Results
Among 1453 patients with dyspeptic symptoms, 61.4% fulfilled Rome criteria for functional dyspepsia. Bladder pain syndrome was present in 16.0% of the patients not fulfilling diagnostic criteria for functional dyspepsia, 22.2% of patients with functional dyspepsia alone, and 36.4% of patients with overlapping functional dyspepsia and irritable bowel syndrome (p‐values <0.0001). In patients with bladder pain syndrome overlapping with functional dyspepsia, dyspeptic symptoms severity, anxiety, depression, and insomnia levels were higher while quality of life and sleep quality were reduced (p‐values <0.0001). These results were even more pronounced in case of overlap with irritable bowel syndrome (p‐values <0.0001).
Conclusions and Inferences
Bladder pain syndrome is present in 26.9% of functional dyspepsia patients and is associated with higher gastrointestinal, psychological distresses, and sleep symptom burdens, and with reduced quality of life.
Bladder pain syndrome is present in 26.9% of functional dyspepsia patients and is associated with higher gastrointestinal, psychological distresses and sleep symptom burdens, and with reduced quality of life. We recommend to systematically assess the presence of bladder pain syndrome in patients with functional dyspepsia.
Letter in response to Black et al. (2020) Trindade, Inês A.; Melchior, Chloé; Colomier, Esther ...
Neurogastroenterology and motility,
June 2022, Letnik:
34, Številka:
6
Journal Article
