In such a way, they are digested by colonic bacteria, releasing gas in the intestine. FODMAPs are present in certain foods, including wheat and beans, and may contribute to digestive symptoms like abdominal pain, bloating, and diarrhea since the small intestine poorly absorbs them. Many IBS patients often describe a worsened symptom profile in consuming foods containing the so-called fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs). Furthermore, IBS patients can be categorized into different IBS subgroups based on the predominant bowel pattern (IBS-D: defecation with diarrhea IBS-C: defecation with constipation IBS-M: a mixture of diarrhea and constipation) ( 3). Since there are still no reliable biomarkers, IBS is defined by the presence of characteristic symptoms (mainly recurrent abdominal pain or discomfort with modifications in the stool habit) described by Rome criteria ( 2). This amelioration appears to occur through an overall improvement of the GI barrier, as demonstrated by the reduced intestinal permeability and the decreased levels of markers of intestinal mucosal integrity, mucosal inflammation, and fermentative dysbiosis.Ībout 10–15% of the adult population worldwide is affected by irritable bowel syndrome (IBS), a functional, non-organic gastrointestinal disorder (FGID) that significantly impairs the quality of life ( 1). The diet with Tritordeum-based foods (bread, bakery products, and pasta) significantly reduced IBS-D patients' symptoms. This pilot study aimed to investigate the effects of a 12-week diet with Tritordeum-based foods in substitution of other cereals on the profile of GI symptoms (evaluated by appropriate questionnaire) and the health of the GI barrier (assessed by sugar absorption test and different markers of integrity and functions) in 16 diarrhea-predominant IBS (IBS-D) patients. It is different from classic wheat for its gluten protein composition, with fewer carbohydrates and fructans and a higher content of proteins, dietary fibers, and antioxidants. Tritordeum is a cereal of Spanish origin derived from the hybridization of durum wheat and wild barley. Recent literature describes IBS patients who may experience gastrointestinal (GI) and extra-GI symptoms precipitated by the ingestion of cereals. In the past few years, increasing attention has been given to the pathologic role of specific foods in IBS, like wheat and other cereals. 3Scientific Direction, National Institute of Gastroenterology, IRCCS “Saverio de Bellis”, Castellana Grotte, Bari, Italy.2Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology, IRCCS “Saverio de Bellis”, Castellana Grotte, Bari, Italy.1Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology, IRCCS “Saverio de Bellis”, Castellana Grotte, Bari, Italy. Francesco Russo 1 * Giuseppe Riezzo 1 Michele Linsalata 1 Antonella Orlando 1 Valeria Tutino 2 Laura Prospero 1 Benedetta D'Attoma 1 Gianluigi Giannelli 3
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