Search Results (158)

Background: More than merely determining our sleep pattern, our body’s internal clock also improves the quality of our sleep, alleviates the symptoms of depression, and maintains the balance of our gut flora. Methods: We carried out a 12-week randomized controlled trial with 99 adults from Kolkata, New Delhi, and Pune who reported sleep problems and symptoms of depression or anxiety. Participants received either a probiotic formulated to improve sleep quality and reduce depressive symptoms or a placebo. We tracked sleep using overnight studies and wearable devices, assessed depressive symptoms with standardized questionnaires, and analyzed stool samples to profile gut bacteria and their metabolites using gene sequencing and metabolomics. Advanced statistics and machine learning helped us pinpoint the key microbial and metabolic factors tied to sleep and mental health. Results: At the start, participants with disrupted sleep and depressive symptoms had fewer beneficial gut bacteria like Bifidobacterium and Lactobacillus, more inflammation-related microbes, and lower levels of helpful short-chain fatty acids. These imbalances were linked to poorer sleep efficiency, less REM sleep, and higher depression and anxiety scores. After 12 weeks, those taking the circadian-supporting probiotic saw a statistically significant increase in beneficial gut bacteria, improved sleep efficiency (+7.4%, p = 0.02), and greater reductions in depression and anxiety compared to the placebo. Increases in SCFA-producing bacteria most strongly predicted improvements. Conclusions: Our results show that taking a probiotic supplement can help bring your gut back into balance, support better sleep, and lift symptoms of depression and anxiety. This offers a hopeful and practical option for people looking for real relief from these deeply connected challenges. Full article

Background: Constipation is a common gastrointestinal disorder with a significant impact on quality of life. Methods: Constipation was induced in male ICR mice via 25% cotrimoxazole gavage (20 mL/kg/day for 7 days). Mice were divided into prevention (pre-MBSFL), treatment (MBSFL), and control groups. MBSFL was prepared by fermenting mung bean starch with Lactobacillus plantarum (1:3 w/v ratio, 37 °C for 48 h), and administered via daily oral gavage (250 mg/kg bw) for 14 days. Fecal parameters (water content and first black stool latency), gastrointestinal motility (gastric emptying and small intestinal propulsion), serum biomarkers (NO, VIP, SP, and 5-HT), and intestinal gene expression (5HTR₄, SERT, and MAO_A) were analyzed. Results: MBSFL intervention restored fecal water content by 38%, reduced first black stool latency from 6.2 h to 3.1 h, and improved small intestinal propulsion by 64%. Additionally, it downregulated serum NO (25%) and VIP (32%) while upregulating SP (49%) and 5-HT (78%) levels. Intestinal 5HTR4 and SERT expression increased by 78% and 71%, respectively, with MAOA suppression (25%). Microbial analysis revealed a 140% increase in Dubosiella and 49% in Lactobacillus abundance, alongside a 62% reduction in Mucispirillum. MBSFL contained polysaccharides (12.3% w/w) and organic acids, including hydroxy butyric acid (4.2 mg/mL). Conclusions: MBSFL alleviates constipation through dual mechanisms: modulating 5-HT pathway activity and restoring gut microbiota homeostasis. Full article

Background/Objectives: Adequate bowel preparation is essential for high-quality colonoscopy. The clarity of the final rectal effluent can predict its sufficiency and guide additional preparation if necessary. For an objective and reliable clarity assessment, the stool collection method may be as important as the evaluation itself. This study was designed to compare the sensitivity of clarity assessments of effluent collected using two methods: a disposable cardboard bedpan with a white bag (Group I) and a 50 mL transparent plastic container (Group II). Methods: A prospective, single-center, randomized, comparative study was conducted between August 2024 and January 2025. Based on predefined criteria, 37 of 177 randomized patients were excluded, and 140 were analyzed. Results: Inadequate bowel preparation was correctly identified by a team member in 71% of Group I and 23% of Group II (p = 0.033). In adequate cases, the detection sensitivity was 88% and 85% (Groups I and II, respectively; p = 0.854). Significantly more patients in Group II either withdrew or failed to submit a photograph of the final rectal effluent. Patients’ verbal assessments did not differ significantly between the groups, regardless of bowel preparation quality. Conclusions: Patient self-assessment was an unreliable indicator of bowel cleanliness, highlighting the need for objective, standardized pre-colonoscopy evaluation methods. The use of a disposable cardboard bedpan with a white bag to collect the final rectal effluent may improve the accuracy of predicting inadequate preparation and patient compliance and may allow timely adjustments to bowel cleansing prior to colonoscopy in routine endoscopy practice. Full article

Short bowel syndrome (SBS) is a rare but complex medical condition that requires expertise in management. The etiology in adults is commonly surgical resection for Crohn’s disease or mesenteric ischemia and is classified based on the anatomy of the remaining bowel. An accurate assessment of the anatomy and nutritional and hydration status is necessary. Dietary therapy is essential to induce adaptation in SBS, provide adequate nutritional needs, and manage symptoms including stool burden. As general SBS guidelines on nutritional support and dietary interventions exist, SBS is unique to the individual and nutrition must also be personalized to the individual to improve quality of life. This review will highlight the principles of adaptation, dietary interventions in SBS, as well as future directions for this field. Full article

Chronic constipation is common among older adults, significantly reducing quality of life and increasing healthcare burden. While dietary fiber is a traditional intervention for constipation, its efficacy in elderly populations remains inconclusive. The purpose of this study was to investigate the effects of dietary fiber on stool frequency, frequency of laxative or enema use, intestinal bifidobacteria concentration, stool dry weight, and adverse events in elderly patients with chronic constipation through a systematic review and meta-analysis of randomized controlled trials (RCTs). A comprehensive search of Embase, Web of Science, PubMed, Scopus, and The Cochrane Library databases was performed to identify eligible studies. Seven RCTs involving 187 participants were included. The meta-analysis found no significant improvement in stool frequency with dietary fiber supplementation (SMD = 0.25, 95% CI [−0.488, 0.988], p = 0.507). However, dietary fiber significantly reduced the frequency of laxative or enema use (SMD = −1.224, 95% CI [−1.786, −0.662], p = 0.000) and increased fecal bifidobacteria concentrations (SMD = 5.142, 95% CI [3.716, 6.568], p = 0.000). These findings suggest that dietary fiber supplementation may reduce reliance on laxatives and enhance intestinal microbiota in elderly individuals with chronic constipation. Further robust and clear randomized controlled trials are needed to more accurately determine the most effective dosage and duration of use. Full article

Constipation, a widespread gastrointestinal disorder, imposes significant burdens on healthcare systems the and global health-related quality of life, yet current options remain suboptimal due to limited mechanistic understanding and efficacy limitations. Given the pivotal significance of the interactions between the gut microbiota and the host on governing bowel movement, we employed a multi-modal approach integrating animal experiments, ELISA, histopathology, qRT-PCR, GC-MS, and 16S rRNA metagenomics to evaluate the functional potential of Lactobacillus rhamnosus LRa05 against loperamide-induced constipation in mice. LRa05 treatment markedly alleviated constipation symptoms, as evidenced by reduced first black stool expulsion time, increased fecal moisture, and enhanced intestinal motility. Mechanistic investigations revealed that LRa05 balanced gastrointestinal regulatory peptides. It also downregulated aquaporin (AQP4/AQP8) mRNA levels and activated the SCF/C-Kit signaling pathway. These effects contributed to the restoration of intestinal peristalsis. Furthermore, LRa05 rebalanced gut microbiota composition by enriching beneficial, including Alloprevotella and Lachnospiraceae NK4A136, key SCFA producers. Thus, LRa05 could boost short chain fatty acid (SCFA) production, which is vital for stimulating intestinal motility, improving mucosal function, and relieving constipation. These findings demonstrated that LRa05 could mitigate constipation through a multi-target mechanism: regulating motility-related gene transcription, restructuring the microbial community, balancing gastrointestinal peptides, repairing the colonic mucosa, and promoting SCFAs for fecal hydration. Our study positions LRa05 as a promising probiotic candidate for constipation management. Full article

Gastrointestinal symptoms, including reflux, bloating, dyspepsia, stomach pain, and altered bowel patterns, are commonly reported in individuals with severe obesity and may significantly impact quality of life. Background/Objectives: Curcumin, a bioactive compound found in turmeric (Curcuma longa L.), possesses anti-inflammatory and antioxidant properties and has been investigated for its potential role in gastrointestinal health. However, its effects in individuals with severe obesity remain unclear. Methods: This double-blind, placebo-controlled clinical trial aimed to evaluate the effect of curcumin supplementation on gastrointestinal symptoms in women with severe obesity. Thirty-one women with a body mass index (BMI) ≥ 40 kg/m² undergoing bariatric surgery were randomized to receive either 1500 mg of curcumin (98.75%) or a placebo (1500 mg corn starch) daily for 13 weeks. Gastrointestinal symptoms were assessed using the Gastrointestinal Symptom Rating Scale (GSRS), and stool consistency was assessed using the Bristol Stool Scale. Anthropometric measurements were also collected. Results: Participants had an average age of 33.1 ± 8 years and a BMI of 45.6 ± 3.31 kg/m². No differences were observed between groups at baseline. At the end of the study, the curcumin group showed a significant reduction in the GSRS’s total score compared to the placebo group (p = 0.002), with improvements in eructation (p = 0.011) and constipation (p = 0.007). Additionally, the curcumin group showed reduced BMI (p = 0.019) and neck circumference (p = 0.042). Conclusions: These findings suggest that curcumin supplementation may alleviate some gastrointestinal symptoms and improve anthropometric measures in women with severe obesity, providing a potential dietary strategy. Full article

Vestibulodynia is vulvodynia localized to the vulvar vestibule and is a chronic disease defined as vulvar pain of at least three months’ duration, without a defined cause, that severely affects women’s health and quality of life with limited treatment options. We collected stool and vaginal samples from 30 women affected by vestibulodynia and 27 healthy women. Bacterial gut and vaginal microbiomes were characterized by amplicon sequencing, and compositional and functional differences between the control and the patient groups were assessed. No differences in vaginal or fecal alpha and beta diversity were found, but vaginal microbiota of patients was found to be associated with Lactobacillus iners. Moreover, the relative abundance of L. iners negatively correlated with the relative abundance of L. crispatus, and positive correlations between commensals and pathobionts were found in the vestibulodynia vaginal microbiota but not in the healthy controls. The bacterial functions and contributors were defined in the study groups for the fecal and vaginal microbiota. Our results portrayed the vaginal microbiome of patients with vestibulodynia as potentially not as efficient at living in an anaerobic environment as the healthy microbiome is and too inclined to acidify this environment, exposing it to the risk of developing other ailments. Full article

Consumption of contaminated drinking water is known to cause waterborne diseases such as diarrhoea, dysentery, typhoid, and hepatitis. This study applied whole-genome sequencing (WGS) to detect, identify, compare, and profile diarrhoeagenic pathogens (Vibrio cholerae, Shiga toxin-producing Escherichia coli, and Escherichia coli O157:H7) from 3168 water samples and 135 faecal samples (human and animal). Culture-based methods, MALDI-TOF mass spectrometry, and PCR were employed prior to WGS for identification of pathogens. Culture-based results revealed high presumptive prevalence of STEC (40.2%), V. cholerae (37.1%), and E. coli O157:H7 (22.7%). The MALDI-TOF confirmed 555 isolates with V. cholerae identified as Vibrio albensis. Shiga toxin-producing Escherichia coli (STEC) was more prevalent in wastewater (60%), treated water (54.1%), and groundwater (36.8%). PCR detected 46.4% of virulence genes from the water isolates and 66% of virulence genes from the STEC stool isolates. WGS also revealed STEC (92.9%) as the most prevalent species and found common virulence (e.g., hcp1/tssD1 and hlyE) and resistance (e.g., acrA and baeR) genes in all three types of samples. Five resistance and thirteen virulence genes overlapped among treated water and stool isolates. These findings highlight the diarrhoeagenic pathogens’ public health risk in water sources and underscore the need for better water quality monitoring and treatment standards. Full article

Background: The disruption of the intestinal barrier and the imbalance of the gut microbiota (GM) seem to play a major role in the complex pathogenesis of irritable bowel syndrome (IBS). Specific microbial strains could improve the gut microenvironment, promoting anti-inflammatory pathways; similarly, vitamin D supplementation could play a role in enhancing the barrier integrity and modulating the immune response in the gut. This study aims to evaluate the efficacy of a new multistrain probiotic, combined with vitamin D, in improving gut barrier function in IBS without constipation. Methods: In this phase IIb double-blind randomized placebo-controlled, parallel-group, multicenter, clinical trial, 35 patients were treated for 12 weeks with OttaBac^®, a high concentration multistrain probiotic plus cholecalciferol, or placebo and were followed up until week 16. Symptoms, quality of life, intestinal permeability, fecal biomarkers, and microbiota composition were evaluated at 0, 12, and 16 weeks. Results: Mean zonulin values showed a significant progressive reduction in the active group (−10.2 ng/mL at week 12, p = 0.0375; −19.5 ng/mL at week 16, p = 0.0002), with a significant difference between groups at week 16 in the per-protocol population (−19.01, p = 0.0053). The active group showed a more stable trend toward improvement in stool frequency and consistency at both week 12 and 16, with a significant improvement compared to the baseline and to the placebo group (−23.2, p = 0.0265, and 5.57 vs. −23.2, p = 0.0492, respectively). No differences were found in regards to the lactulose/mannitol ratio, Irritable Bowel Syndrome Severity Scoring System (IBS-SSS) and Short Form Health Survey (SF-36) total scores, plasmalemmal vesicle associated protein-1 (PV-1), and citrulline levels. In the active group, Bifidobacterium animalis subsp. lactis and Streptococcus thermophilus levels were increased (p < 0.05), while those for Lachnospira were decreased (p < 0.05), and significant changes in Actinobacteria and Proteobacteria were observed (p < 0.05). Lactate (p < 0.01) and acetate (p < 0.05) levels increased post-treatment. Correlation analysis pointed out a significant association between the microbial biomarkers and the symptoms (p < 0.05). Conclusions: Probiotic plus vitamin D could improve IBS-associated symptoms through gut microbiota modulation and gut barrier enhancement, with persistent benefits after treatment discontinuation. Full article

Diarrhea-predominant irritable bowel syndrome (IBS-D) is a functional gastrointestinal disorder characterized by altered motility, abdominal pain, and dysbiosis—particularly reduced biodiversity and a lower abundance of butyrate-producing bacteria. Strategies that modulate the gut microbiota may offer therapeutic benefit. Clostridium butyricum (C. butyricum) CBM588 is a butyrate-producing probiotic with immunomodulatory properties and potential efficacy in treating gastrointestinal disorders. This pragmatic, prospective, open-label, single-arm interventional study assessed the clinical, microbial, and safety-related effects of an 8-week CBM588 supplementation, along with a low-fiber and low-residue diet, in 205 patients with IBS-D who attended Quisisana Nursing Home Hospital, Rome, Italy, between November 2024 and February 2025. The primary outcomes included the global symptom response, the Bristol Stool Scale (BSS), stool frequency, diarrhea episodes, abdominal pain (severity and frequency), bloating, bowel dissatisfaction, quality of life (QoL), safety, and treatment tolerability—measured using the IBS Symptom Severity Scale (IBS-SSS) and a standardized tolerability scale. CBM588, in patients treated with a low-fiber and low-residue diet, significantly improved all clinical endpoints, with a >80% reduction in diarrhea episodes; ~60% reductions in stool frequency and abdominal pain; and >50% improvements in bloating, bowel dissatisfaction, and QoL. Treatment was well tolerated (mean tolerability score 8.95 ± 0.88), with >95% adherence, and no serious adverse events were reported. The secondary outcomes included changes in gut microbiota. In a subset of patients, 16S rRNA gene sequencing showed increased α-diversity and enrichment of butyrate-producing genera (Agathobacter, Butyricicoccus, Coprococcus), which correlated with symptom improvement. Bloating increased in some patients, possibly related to fermentation activity. These findings support the C. butyricum CBM588 probiotic strain as a safe, well-tolerated, and microbiota-targeted intervention for IBS-D. Randomized controlled trials are warranted to confirm efficacy. Full article

Background: Approximately 20% of patients with irritable bowel syndrome (IBS) link symptoms to food intake; a low-FODMAP diet is effective in managing these symptoms. Aims: To evaluate the effectiveness of the Mediterranean version of the low-FODMAP Diet (MED–LFD) compared to NICE guidelines for IBS and to assess changes in stool volatile compound levels. Methods: 108 patients with Rome IV IBS without constipation were randomized into the MED–LFD or NICE group. Primary endpoints included changes in symptom severity and responder rate (reduction of >50 IBS-SSS points) after intervention and at 6 months. Secondary endpoints assessed quality of life, symptom burden, adequate relief, anxiety/depression levels, and adherence. Volatile compound levels were measured using Gas Chromatography/Mass Spectrometry. Results: At both time points, the MED–LFD group showed a significantly greater improvement in symptom severity (159 ± 80 vs. 253 ± 94 and 168 ± 117 vs. 245 ± 98), responder rates (84.6% vs. 60.8% and 79.1% vs. 52.3%), and adherence (75% vs. 41% and 45% vs. 7%). Similar results were observed for all secondary endpoints, with no serious adverse events reported. The MED–LFD intervention was the strongest independent predictor of being a responder at the first (OR = 6.66; 95%CI = 1.46, 30.4) and second follow-up (OR = 4.85; 95%CI = 1.31, 17.96). Short and branched-chain fatty acids were significantly reduced at both follow-ups. Conclusions: The MED–LFD is superior to NICE recommendations in managing non-constipated IBS symptoms and quality of life. It remains to be proven that reduced volatile compound levels might be an objective marker of response to dietary interventions. ClinicalTrials.gov ID: NCT03997708. Full article

Pediatric lower urinary tract symptoms (LUTS) are influenced by age and coexist with nocturnal enuresis (NE) and bladder-bowel dysfunction (BBD). Urinary tract infections (UTIs) are common and linked to LUTS, though the causal relationship remains unclear. This systematic review aims to analyze microbiome alterations in pediatric LUTS and UTIs. Methods: A systematic review was conducted following PRISMA guidelines. PubMed, Embase, and CINAHL databases were searched for studies analyzing gut and urinary microbiomes in pediatric patients with LUTS and UTIs. Quality assessment was performed using the QUADOMICS checklist. Results: Nine studies published between 2018 and 2024 were included; seven out of nine studies employed prospective designs. Six hundred nineteen patients (44.3% pathology groups, 55.7% controls) were analyzed, with microbiome sequencing performed on stool samples in four studies and urine samples in five studies. UTIs and BBD were associated with reduced alpha diversity and distinct bacterial compositions, while beta diversity analyses revealed distinct clustering of microbiome compositions between affected and healthy groups. The gut microbiome of UTI patients showed alterations in Actinobacteria and Proteobacteria abundance, while voiding dysfunction (VD) was linked to the presence of Fusobacterium nucleatum, Clostridium difficile, and Bacteroides clarus without significant VDSS correlation. Conclusion: This systematic review reveals microbial alterations in pediatric LUTS and UTIs, with lower urinary diversity in UTI patients and sex-specific differences post-puberty. Microbiome-based interventions may offer novel therapeutic strategies for LUTS and UTIs. Full article

Soil-transmitted helminths (STHs) are parasitic worms that impact over 1.5 billion people globally. The Kato–Katz technique analyzes stool samples for STHs, allowing for individual diagnoses of STH infection and the estimation of community-level prevalence. One challenge that arises with the procedure is that lab technicians often struggle to prepare microscope slides of sufficient quality for analysis after one attempt. As a result, Kato–Katz procedures are repeated, wasting time and resources. To aid technicians during in-field slide preparation, we created the Stool Stomper. The Stool Stomper is a user-friendly, handheld mechanical device that applies constant, uniform pressure to stool samples to ensure standardized sample preparation onto microscope slides to improve egg counts. The Stool Stomper was assessed using artificial eggs during in-country testing in a lab setting in Dodoma, Tanzania, by lab technicians with various experience levels, from beginner to advanced. Compared to the traditional method, we found that the Stool Stomper reduced slide preparation time, reduced artificial egg counting time, and standardized artificial egg counts with more consistent and accurate readings. The current pilot study highlights the potential for future development and integration of the Stool Stomper device into the Kato–Katz technique to improve community-based STH treatment. Full article

Introduction: Functional gastrointestinal disorders (FGIDs) are common comorbidities that affect the life quality of children with autism. Objective: This study investigated the link between clinical history and specific colonic fecal microbiota (CFM) markers with the pathophysiology of FGIDs in young children with autism patients. Methods: Thirty-nine young patients (2 and 18 years) were included in the study of FGIDs (+) cases (n = 18) and FGIDs (-) (n = 21) controls. Gastrointestinal disorders were diagnosed by standardized clinical tools (ROMA-IV and six-item gastrointestinal severity index), while bacterial markers, including Bacteroidetes, Firmicutes, Actinomycetes (Phyla); Lactobacillales, Clostridiales, Bifidobacteriales (Orders); B. fragilis, F. prausnitzii, B. longum, D. vulgaris and A. muciniphila (Species), were detected by targeting 16S rRNA and two-step PCR protocol. Results: The overall prevalence of FGIDs was significantly (p < 0.05) associated with cesarean delivery, the duration of milk formula consumption, and the presence of early intestinal symptoms during infancy. Furthermore, Bacteroidetes, Lactobacillales, B. longum, D. vulgaris, and A. muciniphila concentrations were significantly (p ≤ 0.03) higher in stool of patients with moderate symptoms, compared to those who were asymptomatic. Conclusions: Our results suggest that the CFM composition is a potential physiological predictor of FGID pathophysiology in a severity-dependent way in children with autism. Full article