Search Results (216)

Small intestinal bacterial overgrowth (SIBO) refers to an abnormal increase in the number of bacteria in the small intestine and is observed in various diseases. SIBO can also develop after long-term use of proton pump inhibitors (drug-induced SIBO), bariatric surgery, gastrectomy, and other surgeries (postoperative SIBO). The aim of this narrative review is to summarize all of the published information on the treatment of SIBO in as much detail as possible and present it separately for each specific disease and intervention associated with SIBO. The most extensively studied drug for the treatment of SIBO is rifaximin. It eliminates SIBO in 63% of cases; however, most studies lack a control group. Small RCTs assessing the effects of this antibiotic on SIBO have reported conflicting results, and a meta-analysis showed no effect. A large RCT is required to verify the results of uncontrolled studies. Neomycin and norfloxacin showed efficacy in the treatment of SIBO in single RCTs, with elimination rates of 20 and 100%, respectively. Ciprofloxacin, rifamycin, metronidazole, and other antibiotics, as well as ursodeoxycholic acid, showed positive effects for the treatment of SIBO, but only in uncontrolled studies or in comparison with rifaximin or other drugs. The reported elimination rates were 54%, 67%, 79%, and 75%, respectively. Eradication therapy for Helicobacter pylori infection eliminated SIBO at a rate of approximately 70%. Probiotics have been tested for treatment of SIBO in various diseases. VSL#3 and Saccharomyces boulardii CNCM I-745 were effective in RCTs, with elimination rates of 58% and 80%, respectively. In conclusion, when selecting SIBO treatment regimens, those that have demonstrated the greatest efficacy for a specific concomitant disease should be preferred, despite the generally low level of evidence supporting these approaches in most cases. Full article

Lactose intolerance (LI) is a common gastrointestinal disorder caused by reduced intestinal lactase activity, resulting in lactose maldigestion and digestive symptoms, including diarrhea, bloating, and abdominal pain. Supplementation with β-galactosidase-producing probiotics is a potential strategy to improve lactose metabolism and reduce symptoms. In this study, we evaluated the probiotic properties and LI-alleviating efficacy of Lactiplantibacillus (L.) plantarum A458 through integrated in vitro and in vivo analyses. The strain displayed robust survival under simulated gastric and bile environments, maintaining high viability at acidic pH (2.0) and in 0.3–0.5% bile salts. It also demonstrated active fermentation capacity, producing high levels of lactic acid, and showed strong adhesion to Caco-2 cells while effectively inhibiting the invasion of Listeria monocytogenes. In a mouse model of LI, oral administration of L. plantarum A458 reduced systemic inflammation, as evidenced by decreased serum levels of IL-1β, TNF-α, IL-6, and IFN-γ. Additionally, L. plantarum A458 improved hepatic antioxidant defenses by elevating SOD activity and reducing lipid peroxidation and redox imbalance, as indicated by decreased MDA levels and increased GSH/GSSG ratio. Notably, L. plantarum A458 increased jejunal lactase activity. Moreover, 16S rRNA sequencing suggested that L. plantarum A458 modulated the gut microbial community, with higher relative abundance of beneficial taxa and lower relative abundance of potentially pathogenic microbes. Collectively, these findings suggest that L. plantarum A458 shows potential as a probiotic candidate for managing LI, associated with increased lactase activity, reduced inflammation and oxidative stress, and modulated gut microbiota. Full article

The demand for functional foods, particularly probiotics, has increased substantially in recent years. The search for plant-based milk alternatives (PBMA) has also risen, influenced by factors such as lactose intolerance, allergies, veganism, and environmental sustainability. Cashew nut kernels have high nutritional value, and are a suitable alternative for preparing plant-based beverages. Therefore, this study aimed to develop a potentially probiotic cashew nut-based beverage fermented by Lacticaseibacillus casei NRRL B-442. The fermented cashew nut-based beverage was prepared, and its stability was evaluated over a 42-day refrigerated storage period (4 °C). Various parameters were monitored, including pH, viability, and concentration of lactic acid, in addition to sugars. The survival rate of microorganisms following simulated gastrointestinal digestion was also determined. Sensory analysis included word association, hedonic scale, and CATA tests. During fermentation, the microorganism consumed glucose, leading to the production of lactic acid. The fermented drink was stable throughout the refrigerated storage period, with a final viable cell count greater than 12 log CFU/mL. After in vitro digestion, probiotic survival rates were higher than 73% in all the samples analyzed. The sensory analysis showed positive consumer acceptance. No statistically significant difference in overall hedonic acceptance was observed between the CNB sweetened with sucrose and sucralose, although both differed from the commercial fermented milk control in several sensory attributes. These results suggest that the cashew nut-based matrix is a promising alternative for developing functional plant products. This study effectively produced a probiotic beverage from cashew nut kernels with functional potential, providing a new product option for interested consumers. Full article

This study compared oat yoghurt (OY), almond yoghurt (AY), oat–almond yoghurt (OAY), and an unfermented oat–almond milk (OAM) to clarify how blending and lactic fermentation affect fermented plant-based alternatives to yoghurt. Nutritionally, OAY showed a balanced profile (protein 2.87 g/100 g; fat 5.18 g/100 g), intermediate between AY (3.29 g/100 g, 8.89 g/100 g) and OY (2.39 g/100 g, 3.30 g/100 g). Fermentation enhanced physical stability, as OAY showed higher water-holding capacity (58.08%) and high viscosity (5381.49 mPa·s), together with the highest viable lactic acid bacteria count (7.1 log10 CFU/g). Scanning electron microscopy revealed that co-fermentation formed a denser, more cohesive multiphase gel network with reduced pore size compared with OAM and AY. All samples exhibited shear-thinning behavior; dynamic rheology indicated weak gel features (G′ > G″), and OAY showed the highest G′, implying a reinforced network likely associated with interactions between oat β-glucan and almond proteins during fermentation. Volatile profiling by GC–MS identified 117 compounds, and OAY exhibited the greatest total volatiles (523.02 μg/kg), exceeding OY (397.43 μg/kg) and OAM (195.73 μg/kg), indicating improved aroma complexity and consumer acceptability. In conclusion, our study will provide quantifiable formulations for the development of highly acceptable oat and almond-based plant-based yoghurt. Most importantly, it also offers additional dairy products for individuals with gluten allergies and lactose intolerance. Full article

A 27-year-old male presented with chronic diarrhea, bloating, and abdominal pain since age 13. Initially attributed to lactose intolerance, treated with dairy-free diet, symptoms persisted despite negative workup—normal celiac serology, stool studies, and abdominal ultrasound. Recent symptoms included severe diarrhea, fatigue, weakness, 8 kg weight loss, hair loss, elevated IgE and fecal calprotectin. Gastroscopy showed flattened, granular gastric mucosa with focal hyperemia in the antrum and greater curvature. Histology revealed severe chronic inactive H. pylori-negative gastritis with a prominent subepithelial collagen band (verified by Crossmon’s trichrome), confirming collagenous gastritis—a rare entity first described in 1989. The condition has a slight female predominance and bimodal age peaks (adolescence and >60 years). Symptoms are nonspecific, including abdominal pain, diarrhea, weight loss and anemia. Pediatric cases often feature nodular mucosa and anemia; adults more commonly present with watery diarrhea, sometimes linked to collagenous colitis. Diagnosis requires histological features including patchy subepithelial collagen band ≥ 10 μm thick, lymphocytic or eosinophilic infiltration of the lamina propria, epithelial changes and entrapped capillaries. Patterns include atrophic, lymphocytic-like, and eosinophil-rich. Crossmon’s or Masson’s trichrome, Congo red, and tenascin immunohistochemistry aid in proving collagen and excluding amyloidosis. Treatment is mainly symptomatic or with proton pump inhibitors; corticosteroids may be effective in refractory cases. Full article

Lactase enzyme-based products experience challenges including residual lactose that result in lactose intolerance. The purpose of this study was to develop polyelectrolyte polysaccharide-enriched lactase-encapsulated liposomal hydrogel films as an edible coating of Perline Mozzarella cheese that delivers enzymes along with the product on the side of absorption in the small intestine. Coatings were investigated for shelf-life enhancement and in vitro enzyme release behaviour. Two different polymeric hydrogel film formulations were evaluated: lactase-encapsulated liposome-enriched chitosan (PCLLa) and lactase-encapsulated liposome-enriched polyelectrolyte chitosan and sodium alginate (CLLA). Lactase-encapsulated liposomes (mean particle size: 176 nm) were produced using 20% v/v lactase enzyme and 8% w/v lecithin using probe sonication. The edible hydrogel film coatings were applied on Perline Mozzarella cheese using the standard dip-coating method. Shelf-life characteristics of all samples were evaluated using pH, colour change, dry matter determination, microbial evaluation, and sensory analysis. CLLA coatings increased shelf life up to 60 days, displaying a pH of 5.48, continued normal colour, enhanced humidity balance, minimal bacterial growth, and the highest scores for sensory values when compared to both PCLLa (coatings) and the bare cheese substrate (control) samples. Furthermore, CLLA coatings provided greater stability for liposomes within the polyelectrolyte polymeric edible hydrogel film structure. Hence, the combination of liposomes with polyelectrolyte edible hydrogel films provides a novel strategy to enhance lactase enzyme encapsulation (for intolerance), stability, and delivering ability to the small intestine as well as improving the shelf life of coated cheese products. Full article

The common metabolic disorder, lactose intolerance, is often treated with oral lactase enzyme supplements, which can frequently cause gastrointestinal instability. This work utilizes Malbranchea cinnamomea’s AA9 lytic polysaccharide monooxygenase (LPMO) to target β-lactose (β-lactose) in an investigation of a new enzymatic approach for lactose breakdown. Potential possibilities for lactose breakdown are AA9 LPMOs, copper-dependent enzymes that oxidatively cleave glycosidic bonds in polysaccharides. We employed a combined in silico method that incorporated molecular docking, density functional theory (DFT) calculations, and molecular dynamics (MD) simulations. Docking studies revealed that β-lactose formed hydrogen bonds with key residues SER100, ASN54, and ARG56, exhibiting a greater binding affinity (−5.4 kcal/mol) toward LPMO compared to the control citric acid (−4.9 kcal/mol). Upon DFT analysis, (LPMO) showed excellent stability and appropriate reactivity for enzyme interaction. The higher stability of the LPMO-β-lactose complex was highlighted by MD simulation over 100 ns, which showed lower root mean square deviation (RMSD) and root mean square fluctuation (RMSF) values, greater structural compactness, and reduced solvent accessibility when compared to the control. These collective findings suggest that β-lactose interacts efficiently with the AA9 LPMO active site, supporting its potential as a novel enzymatic target for lactose degradation. This computational study provides a theoretical foundation for developing alternative therapeutic strategies for lactose intolerance, though further in vitro and in vivo investigations are required to validate these findings. Full article

Background: The Mediterranean diet (MedDiet) has been associated with anti-inflammatory effects and potential benefits in several chronic conditions. However, adherence to the MedDiet and its relationship with lifestyle factors and disease severity across different rheumatological diseases remain poorly characterized. Objectives: This study aimed to evaluate differences in MedDiet adherence among patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and fibromyalgia (FM), and to explore its association with cardiovascular comorbidities, bowel habits, and disease-related outcomes. Methods: In this monocentric cross-sectional study, adherence to the MedDiet was assessed using the 14-item PREDIMED questionnaire. Self-reported data on sociodemographic characteristics, cardiovascular comorbidities, bowel habits, and dietary behaviors were collected through questionnaires. Disease activity and severity were assessed using validated disease-specific measures. Differences in MedDiet adherence across diagnostic groups were evaluated using non-parametric tests. Multivariable models were performed to examine associations between MedDiet adherence and cardiovascular comorbidities or disease outcomes, adjusting for potential confounders including age, sex, BMI, smoking status, and educational level. Results: A total of 422 participants were included (RA n = 165, PsA n = 85, FM n = 172). Significant differences in MedDiet adherence were observed across diagnostic groups (p < 0.001), with the highest adherence in RA, intermediate values in PsA, and the lowest in FM. Compared with the other groups, a higher proportion of FM participants reported food intolerances (46.5%) and restrictive diets, including lactose-free (34.9%) and gluten-free (15.1%) diets. In the FM group, high adherence to the MedDiet was significantly associated with lower FIQR scores (β = −16.9; 95% CI −32.1 to −1.7; p = 0.01) and lower PDS scores (β = −4.34; 95% CI −7.81 to −0.86; p = 0.01). Sensitivity analyses using the continuous PREDIMED score confirmed these associations. Conclusions: Adherence to the MedDiet differs across rheumatological diseases, with the lowest adherence observed in FM. Higher adherence was associated with lower disease severity and impact in FM. These findings highlight the potential relevance of nutritional counselling in rheumatological diseases and support the need for longitudinal and interventional studies evaluating the role of the MedDiet within multidisciplinary disease management. Full article

Diet is a major modifiable determinant of gastrointestinal (GI) health, influencing disease risk and progression through coordinated effects on the gut microbiome, immune regulation, epithelial barrier integrity, oxidative balance, and epigenetic mechanisms. This narrative review synthesizes epidemiological, mechanistic, and clinical evidence from the past decade to examine bidirectional relationships between dietary patterns and seven common GI disorders: celiac disease, irritable bowel syndrome (IBS), Crohn’s disease, ulcerative colitis, Helicobacter pylori-associated gastritis, peptic ulcer disease, and lactose intolerance. Western dietary patterns, characterized by high intake of ultra-processed foods and saturated fats and low fiber consumption, are consistently associated with microbial dysbiosis, impaired barrier function, and enhanced inflammatory signaling. In contrast, Mediterranean and plant-forward dietary patterns show protective associations across multiple GI conditions. Mechanistically, diet influences GI pathophysiology largely through microbiome-derived metabolites, particularly short-chain fatty acids, which regulate epithelial homeostasis, immune tolerance, and inflammatory pathways. Condition-specific dietary strategies remain clinically important. Gluten exclusion is essential in celiac disease, low- fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) approaches provide evidence-based symptom control in IBS, and exclusive enteral nutrition or targeted exclusion diets support remission induction in Crohn’s disease. Selected probiotics and emerging postbiotics may provide adjunctive benefits in specific contexts. Despite growing evidence, dietary research remains limited by methodological heterogeneity and interindividual variability. Precision nutrition approaches integrating microbiome profiling and artificial intelligence represent a promising translational direction. Overall, dietary patterns—rather than isolated nutrients—form the foundation of GI dietary therapy. Full article

Water kefir is a non-dairy fermented water drink which includes lactic acid bacteria, acetic acid bacteria and yeasts which provide probiotic as well as antioxidant properties. Prunus armeniaca (apricot) is a promising raw material to develop a functional beverage because it is rich in carotenoids, vitamins, and phenolics. Coconut water is a natural hydrating substance and plant-based substrate. The aim of this study was to prepare and characterize apricot-coconut water kefir beverage, (ACWB) a fermented beverage having 20 g (w/v) dried apricot, 8 g (w/v) brown sugar, and 8 g (w/v) water kefir grains fermented together in 100 mL coconut water and compare its physicochemical, microbial, and antioxidant properties with a control sample excluded with dried apricot but having same concentration of rest of the ingredients. After fermentation, total soluble solids (TSS), pH, titratable acidity (TA), water activity (aw), total bacterial count (TBC), DPPH radical-scavenging activity, and total phenolic contents (TPC) were measured. ACWB exhibited significantly higher values (p < 0.05) in terms of TSS (10.07 ± 0.01 °Brix), TA (0.298 ± 0.01%), and TBC (1.92 × 10⁷ CFU/mL), with lower pH (3.98 ± 0.07) and aw (0.94 ± 0.02) compared to the control. Enhanced antioxidant activity (DPPH = 62.7 ± 0.86%) and TPC (19.92 ± 0.32 mg CE/100 mL) confirmed its superior bioactive potential. Sensory evaluation of ACWB also found it to be more preferred, with statistically significant difference in majority of the tested attributes. The apricot supplement enhanced the fermentation activity, microbial growth, as well as the antioxidant capacity of the end product, creating a stable, tangy, and nutritionally enriched non-dairy functional beverage that could be consumed by healthy and lactose intolerant consumers. Full article

The increasing demand for plant-based alternatives, driven by veganism, lactose intolerance, and greater health consciousness, has intensified research into dairy-free frozen desserts. This study investigates the development of a plant-based ice cream alternative utilizing oleosomes extracted from sunflower seed kernels as natural emulsifiers, eliminating the need for synthetic additives. Oleosomes were obtained through aqueous extraction from raw kernels, incorporated into emulsions in three levels (0, 12, and 24%), and combined with sunflower seed oil, tahini, date paste, and water to create the ice cream (IC) formulations. The physicochemical properties of three formulations of a sugar-free frozen dessert were studied. Physicochemical analyses assessed nutritional value, color (CIELab), melting time, stability, overrun, viscosity, and texture profile (TPA). Sensory evaluation was conducted using a hedonic test to assess the impact of tahini type (sunflower seed tahini or pumpkin seed kernel tahini) on the product acceptance. Results showed that higher oleosome content improved emulsion stability and melting resistance, while also producing a softer (30.74 ± 0.28 N), less adhesive (1.87 ± 0.20 mJ) texture, suitable for plant-based ice cream. Sensory analysis revealed a clear preference for the pumpkin tahini formulation, which scored 8.21 ± 0.62 for overall appreciation. The findings demonstrate that the addition of oleosome might improve textural attributes of the products, while the consumer preference could also be influenced by the type of tahini involved in the formulation. However, further studies are necessary to corroborate the proposed interaction mechanisms of ingredients. Full article

Mare and donkey milk have attracted scientific and commercial interest due to their distinctive biochemical composition and functional potential as nutritional sources. Their compositional similarity to human milk—particularly regarding lactose content, protein profile, and mineral balance—makes them relevant alternatives for individuals with bovine milk intolerance and suitable candidates for nutraceutical and biomedical research. This systematic review provides an overview of the physicochemical properties of the milk of these species, examining the influence of breed, diet, and lactation stage on yield and composition. Particular attention is given to bioactive compounds, including lysozyme, lactoferrin, and immunoglobulins, which have been associated with antimicrobial, anti-inflammatory, and immunomodulatory activities. The review also discusses technological processing methods, such as fermentation, pasteurization, and lyophilization, and their effects on functional and therapeutic properties. Finally, current challenges in production and research are addressed, including the need for standardized protocols, sustainable management strategies, and further investigation into the health-related properties of mare and donkey milk. Full article

A novel two-in-one sensor for both carbon dioxide and hydrogen detection has been obtained based on a hybrid heterostructure. It consists of a 30 nm thick TiO₂ nanocrystalline film grown by atomic layer deposition (ALD), thermally annealed at 610 °C, and subsequently coated with bimetallic AgAu nanoparticles and covered with a PV4D4 nanolayer, which was thermally treated at 430 °C. Two types of gas response behaviors have been registered, as n-type for hydrogen gas and p-type semiconductor behavior for carbon dioxide gas detection. The highest response for carbon dioxide has been registered at an operating temperature of 150 °C with a value of 130%, while the highest response for hydrogen gas was registered at 350 °C with a value of 230%, although it also attained a relatively good gas selectivity at 150 °C. It is considered that a thermal annealing temperature of 610 °C is better for the properties of TiO₂ nanofilms, since it enhances gas sensor sensitivity too. Polymer coating on top is also believed to contribute to a higher influence on selectivity of the sensor structure. Accordingly, to our previous research where PV4D4 has been annealed at 450 °C, in this research paper, a lower temperature of 430 °C for annealing has been used, and thus another ratio of cyclocages and cyclorings has been obtained. Knowing that the polymer acts like a sieve atop the sensor structure, in this study it offers increased selectivity and sensitivity towards carbon dioxide gas detection, as well as maintaining a relatively increased selectivity for hydrogen gas detection, which works as expected with Ag and Au bimetallic nanoparticles on the surface of the sensing structure. The results obtained are highly important for biomedical and environmental applications, as well as for further development of the sensor industry, considering the high potential of two-in-one sensors. A carbon dioxide detector could be used for assessing respiratory markers in patients and monitoring the quality of the environment, while hydrogen could be used for both monitoring lactose intolerance and concentrations in cases of therapeutic gas, as well as monitoring the safe handling of various concentrations. Full article

Background/Objectives: β-galactosidase (lactase) is a transformative enzyme used in many different fields. Its significance spans from biotechnology to food and pharmaceutical industries. β-galactosidase catalyzes the hydrolysis of lactose into glucose and galactose. In medicine, β-galactosidase has gained attention and has many applications, mainly in enzyme replacement therapy. β-galactosidase is the main active ingredient of medications for lactose intolerance. Industrially β-galactosidase is typically produced by the Aspergillus oryzae filamentous fungus. Therapeutic interventions involving β-galactosidase aim to mitigate symptoms and improve the patients’ quality of life. In the food industry, it plays a crucial role in the production of lactose-free products, improving accessibility to dairy products. However, despite its versatility and wide use, challenges connected to β-galactosidase still exist, such as the need for cost-effective and more efficient methods for administering the enzyme. Additionally, there are several ongoing studies that seek to enhance stability and optimize the performance of β-galactosidase in various applications. The aim of this manuscript is to summarize current knowledge about β-galactosidase as an active ingredient and to present some preparations that are commercially available or mentioned in the literature. Methods: A systematic search was conducted in PubMed, Scopus, Embase and Web of Science to identify relevant articles on formulations related to β-galactosidase, focusing on original research articles published between 1895 and 2025 that exclusively examine the use of oral drug delivery. Results: After a rigorous search across multiple databases, 45 relevant studies out of 1633 initial results were selected for analysis. Conclusions: β-galactosidase remains a highly versatile enzyme with broad industrial and medical relevance. While current formulations offer significant benefits, further innovation is needed to improve delivery efficiency, stability, and cost-effectiveness. The findings of this review contribute to a deeper understanding of β-galactosidase as an active ingredient and outline opportunities for advancing its application in oral drug delivery systems. Full article

Background/Objectives: A gluten-free diet (GFD) remains the only effective therapy for celiac disease (CD) and non-celiac gluten sensitivity (NCGS). Strict adherence is essential, yet it can impose considerable psychological, social, and financial burdens. This study investigated factors influencing GFD adherence, explored the perceived burden of this therapy, and examined differences between individuals with CD and NCGS. Methods: A cross-sectional anonymous questionnaire was completed by 681 Romanian citizens living in Romania with either a medically confirmed or a self-reported diagnosis of CD or NCGS. The survey assessed GFD adherence and its potential predictors, including gender, family history, comorbidities, diagnostic confirmation, and food security and perceived availability, as well as various psychological, social, and financial factors. Results: Participants with CD showed significantly higher GFD adherence than those with NCGS. Self-diagnosis was more common among NCGS respondents and was associated with poorer adherence, whereas a medically confirmed diagnosis predicted stricter adherence. Longer time since diagnosis, a greater perceived importance of a GFD, consistent label reading, as well as weight gain after starting a GFD were also positively associated with adherence. Although gluten-free (GF) food security has improved over time, cost remains a major barrier. Social activities negatively influenced adherence, reflecting the isolating effects of dietary restrictions. Nearly 25% of respondents reported a family history of gluten-related disorders (GRDs). Women—although more frequently affected by GRDs—exhibited levels of adherence similar to men. Comorbidities were common (33.9%), predominantly autoimmune diseases (56.3%), with autoimmune thyroiditis (32%) and lactose intolerance (19.2%) being the most frequent comorbidities. Conclusions: Diagnostic certainty, motivation, and practical barriers influence GFD adherence. Enhanced public awareness, clear labeling, improved GF food security, and financial support could facilitate sustained adherence and reduce psychosocial burden. To the author’s knowledge, this is the first national study of its kind in Romania. Full article