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Probiotics and Antibiotics for IBS: Do Bacteria Matter

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Probiotics and Antibiotics for IBS: Do Bacteria Matter

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    1. Probiotics and Antibiotics for IBS: Do Bacteria Matter?

    2. The normal healthy intestinal flora (left) is heavily colonized with Probiotics (Lactobacilli, Bifidobacteria, and the such).The normal healthy intestinal flora (left) is heavily colonized with Probiotics (Lactobacilli, Bifidobacteria, and the such).

    5. This research is focusing on different levels of the brain-gut axis At the level of the ... Our main interest is currently in the level of the CNS However, with your help we would like to expand our research to the transmission pathways. This research is focusing on different levels of the brain-gut axis At the level of the ... Our main interest is currently in the level of the CNS However, with your help we would like to expand our research to the transmission pathways.

    9. PRD 4% vs 0.3%PRD 4% vs 0.3%

    17. Evacuation of intestinal gas in patients with irritable bowel syndrome (IBS) (n=20) and healthy subjects (n=20). Gas was infused into the intestine at a constant rate (represented by the broken line) for two hours and collected via an anal cannula. Note that IBS patients expelled a significantly lower volume of gas. Values are means (SEM). **p<0.01. Individual perception scores and gas retention after a two hour intestinal gas infusion in patients with irritable bowel syndrome (IBS) and healthy subjects. Perception of abdominal symptoms was scored on a seven point scale (0-6). Gas retained is volume infused minus volume evacuated. Broken lines represent the upper limits for perception (score 3 that is, mild to moderate) and gas retention (400 ml, see text) in healthy subjects. Only 4/20 healthy subjects progressively retained gas exceeding 400 ml. In contrast, most IBS patients (18/20) retained gas (>400 ml) and/or developed moderate to severe symptoms (>3 perception score). Figure 3   Individual abdominal distension and gas retention after a two hour intestinal gas infusion in patients with irritable bowel syndrome (IBS) and healthy subjects. Gas retained is volume infused minus volume evacuated. Note that in contrast with healthy subjects, most IBS patients (17/20) retained gas (>400 ml) and/or developed abdominal distension (>3 mm girth increment). Evacuation of intestinal gas in patients with irritable bowel syndrome (IBS) (n=20) and healthy subjects (n=20). Gas was infused into the intestine at a constant rate (represented by the broken line) for two hours and collected via an anal cannula. Note that IBS patients expelled a significantly lower volume of gas. Values are means (SEM). **p<0.01.

    18. Retained Gas and IBS symptoms Evacuation of intestinal gas in patients with irritable bowel syndrome (IBS) (n=20) and healthy subjects (n=20). Gas was infused into the intestine at a constant rate (represented by the broken line) for two hours and collected via an anal cannula. Note that IBS patients expelled a significantly lower volume of gas. Values are means (SEM). **p<0.01. Individual perception scores and gas retention after a two hour intestinal gas infusion in patients with irritable bowel syndrome (IBS) and healthy subjects. Perception of abdominal symptoms was scored on a seven point scale (0-6). Gas retained is volume infused minus volume evacuated. Broken lines represent the upper limits for perception (score 3 that is, mild to moderate) and gas retention (400 ml, see text) in healthy subjects. Only 4/20 healthy subjects progressively retained gas exceeding 400 ml. In contrast, most IBS patients (18/20) retained gas (>400 ml) and/or developed moderate to severe symptoms (>3 perception score). Figure 3   Individual abdominal distension and gas retention after a two hour intestinal gas infusion in patients with irritable bowel syndrome (IBS) and healthy subjects. Gas retained is volume infused minus volume evacuated. Note that in contrast with healthy subjects, most IBS patients (17/20) retained gas (>400 ml) and/or developed abdominal distension (>3 mm girth increment). Evacuation of intestinal gas in patients with irritable bowel syndrome (IBS) (n=20) and healthy subjects (n=20). Gas was infused into the intestine at a constant rate (represented by the broken line) for two hours and collected via an anal cannula. Note that IBS patients expelled a significantly lower volume of gas. Values are means (SEM). **p<0.01.

    20. Intestinal bacteria and gut function Most of our knowledge on the effect of intestinal microflora on gut motor and sensory function come from studies in germ-free animals. Most of our knowledge on the effect of intestinal microflora on gut motor and sensory function come from studies in germ-free animals.

    21. Intestinal bacteria and gut function

    22. Intestinal bacteria and gut function

    23. Intestinal bacteria and gut function Rabbits were treated with intravenously injected LPS. After 90 min animals were killed and intestinal segments were mounted in an organ bath. Lipopolysaccharide (0.2 lg kg)1) (bacterial endotoxin) inhibited K+-induced contractions (60 mm) by 68% in duodenum, 58% in jejunum and 52% in ileum. The LPS (0.2 lg kg)1, 90 min) reduced K+-induced contractions in three intestinal segments at all concentrations of K+. Lipopolysaccharide (LPS) is an endotoxin in the cell wall of Gram-negative bacteria (Hewett & Roth 1993) which inhibits NaCl absorption in the small intestine (Guandalini et al. 1982) and reduces l-leucine transport in rabbit jejunum (Abad et al. 2001). The LPS can also help to relax skeletal muscle (Gutierrez et al. 1995), cardiac muscle (Brady et al. 1992) and vascular smooth muscle (Schneider et al. 1994). In vivo experiments in pigs have shown that endotoxin inhibits gastric motility Rabbits were treated with intravenously injected LPS. After 90 min animals were killed and intestinal segments were mounted in an organ bath. Lipopolysaccharide (0.2 lg kg)1) (bacterial endotoxin) inhibited K+-induced contractions (60 mm) by 68% in duodenum, 58% in jejunum and 52% in ileum. The LPS (0.2 lg kg)1, 90 min) reduced K+-induced contractions in three intestinal segments at all concentrations of K+. Lipopolysaccharide (LPS) is an endotoxin in the cell wall of Gram-negative bacteria (Hewett & Roth 1993) which inhibits NaCl absorption in the small intestine (Guandalini et al. 1982) and reduces l-leucine transport in rabbit jejunum (Abad et al. 2001). The LPS can also help to relax skeletal muscle (Gutierrez et al. 1995), cardiac muscle (Brady et al. 1992) and vascular smooth muscle (Schneider et al. 1994). In vivo experiments in pigs have shown that endotoxin inhibits gastric motility

    24. Intestinal bacteria and gut function

    27. ..

    29. The benefit of the use of probiotics in IBS remains to be proven It is possible that probiotics might have a clinical benefit in certain subgroups of patients, particularly those with D-IBS, PI-IBS, SBBOG. The benefit of the use of probiotics in IBS remains to be proven It is possible that probiotics might have a clinical benefit in certain subgroups of patients, particularly those with D-IBS, PI-IBS, SBBOG.

    30. Twenty-five patients with diarrhoea-predominant irritable bowel syndrome were randomly assigned to receive VSL#3 powder (450 billion lyophilized bacteria/day) or matching placebo twice daily for 8 weeks after a 2-week run-in period. Twenty-five patients with diarrhoea-predominant irritable bowel syndrome were randomly assigned to receive VSL#3 powder (450 billion lyophilized bacteria/day) or matching placebo twice daily for 8 weeks after a 2-week run-in period.

    31. Twenty-five patients with diarrhoea-predominant irritable bowel syndrome were randomly assigned to receive VSL#3 powder (450 billion lyophilized bacteria/day) or matching placebo twice daily for 8 weeks after a 2-week run-in period. Twenty-five patients with diarrhoea-predominant irritable bowel syndrome were randomly assigned to receive VSL#3 powder (450 billion lyophilized bacteria/day) or matching placebo twice daily for 8 weeks after a 2-week run-in period.

    32. Twenty-five patients with diarrhoea-predominant irritable bowel syndrome were randomly assigned to receive VSL#3 powder (450 billion lyophilized bacteria/day) or matching placebo twice daily for 8 weeks after a 2-week run-in period. Twenty-five patients with diarrhoea-predominant irritable bowel syndrome were randomly assigned to receive VSL#3 powder (450 billion lyophilized bacteria/day) or matching placebo twice daily for 8 weeks after a 2-week run-in period.

    33. Twenty-five patients with diarrhoea-predominant irritable bowel syndrome were randomly assigned to receive VSL#3 powder (450 billion lyophilized bacteria/day) or matching placebo twice daily for 8 weeks after a 2-week run-in period. Twenty-five patients with diarrhoea-predominant irritable bowel syndrome were randomly assigned to receive VSL#3 powder (450 billion lyophilized bacteria/day) or matching placebo twice daily for 8 weeks after a 2-week run-in period.

    34. Seventy-seven subjects with IBS were randomized to receive either Lactobacillus salivarius UCC4331 or Bifidobacterium infantis 35624, each in a dose of 1 × 1010 live bacterial cells in a malted milk drink, or the malted milk drink alone as placebo for 8 weeks. The cardinal symptoms of IBS were recorded on a daily basis and assessed each week. Seventy-seven subjects with IBS were randomized to receive either Lactobacillus salivarius UCC4331 or Bifidobacterium infantis 35624, each in a dose of 1 × 1010 live bacterial cells in a malted milk drink, or the malted milk drink alone as placebo for 8 weeks. The cardinal symptoms of IBS were recorded on a daily basis and assessed each week.

    35. Intestinal bacteria and gut function Mononuclear IL-10/IL-12 ratios at baseline and following therapy with placebo, lactobacillus, and bifidobacteria in IBS and controls. Note the abnormal baseline ratio in subjects with IBS compared to controls, with a normalization of this ratio following the administration of B infantis. O’Mahony L, et al. Gastroenterology 2005;128 (3):541-551. Mononuclear IL-10/IL-12 ratios at baseline and following therapy with placebo, lactobacillus, and bifidobacteria in IBS and controls. Note the abnormal baseline ratio in subjects with IBS compared to controls, with a normalization of this ratio following the administration of B infantis. O’Mahony L, et al. Gastroenterology 2005;128 (3):541-551.

    36. Intestinal bacteria and gut function Mononuclear IL-10/IL-12 ratios at baseline and following therapy with placebo, lactobacillus, and bifidobacteria in IBS and controls. Note the abnormal baseline ratio in subjects with IBS compared to controls, with a normalization of this ratio following the administration of B infantis. O’Mahony L, et al. Gastroenterology 2005;128 (3):541-551. Mononuclear IL-10/IL-12 ratios at baseline and following therapy with placebo, lactobacillus, and bifidobacteria in IBS and controls. Note the abnormal baseline ratio in subjects with IBS compared to controls, with a normalization of this ratio following the administration of B infantis. O’Mahony L, et al. Gastroenterology 2005;128 (3):541-551.

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