Food as Medicine: How to Influence the Microbiome and Improve Symptoms in Patients with Irritable Bowel Syndrome.

Purpose Of Review: This review highlights effects of dietary interventions on the gut microbiome and gastrointestinal symptoms in those with irritable bowel syndrome (IBS).

Recent Findings: It is hypothesized that gut dysbiosis factors into the pathophysiology of IBS. Various diets that influence the microbiome and intestinal physiology may have therapeutic properties.

Dietary Intake and Systemic Inflammation: Can We Use Food as Medicine?

Purpose Of Review: This review summarizes the current literature regarding the association between diet and systemic inflammation.

Recent Findings: Data in humans suggests that consumption of plant-based nutrients is associated with a reduction in systemic inflammation, while consumption of red meat and excessive dairy has the opposite effect and may increase risk of acute flares in those that suffer from certain chronic diseases like inflammatory bowel disease or psoriasis and certain cancers. There is a known association between diet and systemic inflammation; thus, we recommend that clinicians discuss plant-based, whole food diets with patients, particularly those that suffer from chronic inflammatory diseases as an adjunct treatment for these conditions.

Intragastric Balloon Significantly Improves Metabolic Parameters at 6 Months: a Meta-Analysis.

Introduction: It is estimated that by 2030, 38% of the world population will be overweight, and another 20% will be people with obesity. Intragastric balloons (IGBs) are an option in conjunction with lifestyle modification for the treatment of obesity. We sought to investigate the effects of IGB therapy on hemoglobin A1c (A1c), systolic and diastolic blood pressure (SBP, DBP), total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides (TGs).

Impact of Obesity on Inflammatory Bowel Disease.

Purpose Of Review: This review highlights recent work that evaluates the impact of obesity on inflammatory bowel disease (IBD) pathogenesis and management.

Recent Findings: The impact of obesity on IBD prevalence, clinical course, and management, has been studied and described more so in recent years. Studies have shown that obesity increases IBD disease activity, leads to longer hospitalization courses, and increases the likelihood of the development of extraintestinal manifestations.

Functional hypogonadism among patients with obesity, diabetes, and metabolic syndrome.

Testosterone deficiency, defined as low total testosterone combined with physical, cognitive, and sexual signs and/or symptoms, is a common finding in adult men. Functional hypogonadism (FH) is defined as borderline low testosterone (T) secondary to aging and/or comorbid conditions such as diabetes, obesity, and/or metabolic syndrome. The relationship between FH and metabolic disorders is multifactorial and bidirectional, and associated with a disruption of the hypothalamic-pituitary-gonadal axis.

Natural Alternative Sweeteners and Diabetes Management.

Purpose Of Review: The goal of this review is to discuss the data on natural alternative sweeteners and their effects on glucose homeostasis and other metabolic parameters within the past five years. We sought to answer whether common natural alternative sweeteners have a positive or negative effect on glucose control in both human and animal models, and whether the data supports their widespread use as a tool to help reduce the prevalence of diabetes and associated comorbid conditions.

Recent Findings: Recent studies suggest that natural alternative sweeteners may reduce hyperglycemia, improve lipid metabolism, and have antioxidant effects particularly in those that have baseline diabetes.

Protein Supplementation in Sport: Source, Timing, and Intended Benefits.

Purpose Of Review: The purpose of this review is to provide background on the present literature regarding the utility and effectiveness of protein supplements, including protein source and nutrient timing.

Recent Findings: In the setting of adequate dietary protein consumption, research suggests some benefit particularly in sport or exercise activities. Protein supplements command a multi-billion-dollar market with prevalent use in sports.

Nutrition in Patients With Cirrhosis.

Malnutrition is a common complication of cirrhosis, increases in frequency with Child-Turcotte-Pugh (CTP) score, and is associated with an increased morbidity and mortality. Although malnutrition is easily recognized in chronically ill patients with CTP class C cirrhosis, it is present but often unrecognized in up to 50% of patients with CTP class A cirrhosis; thus, all patients with cirrhosis, regardless of etiology or severity, should be screened for malnutrition. A nutritional screening should be incorporated into the routine clinical care of patients with cirrhosis, with a more extensive nutritional assessment that includes a detailed history, dietary recall, baseline nutrition laboratory tests, and evaluation of sarcopenia using imaging modalities or strength testing to determine the degree of frailty.

Nutrition in Cirrhosis.

Purpose Of Review: This review discusses the prevalence of malnutrition in cirrhosis, metabolic functions of the liver and alterations in cirrhosis, malnutrition screening tools, and common macronutrient and micronutrient deficiencies encountered in individuals with chronic liver disease and their impact on morbidity and mortality.

Recent Findings: Several meta-analyses and international society guidelines recommend malnutrition screening and nutrition interventions to improve outcomes in all patients with chronic liver disease given their high risk of malnutrition which is often under recognized. Malnutrition is common in individuals with chronic liver disease and has a significant impact on patient outcomes.

Who Should Be Gluten-Free? A Review for the General Practitioner.

Historically, a gluten-free diet was recommended only for those with celiac disease or IgE-mediated wheat allergy. With changes in food allergy labeling in the United States and the publication of several best-selling books, gluten-related disorders have come to the forefront of popular culture. As a result, there has been a dramatic increase in the number of gluten-free diet followers, many for nontraditional reasons.

Diet and the Role of Food in Common Gastrointestinal Diseases.

Food plays an essential role in normal cellular processes; however, certain foods may also trigger or worsen certain disease states. This article focuses particularly on the role of food in common gastrointestinal and liver diseases, and discusses the current evidence that either supports or debunks common dietary recommendations. Nutrition topics discussed include the use of artificial sweetener for weight loss, avoidance of all dairy products in the setting of lactose intolerance, dietary recommendations for diverticular disease, and dietary management in cirrhotic patients with hepatic encephalopathy.

The Association Between Artificial Sweeteners and Obesity.

Purpose Of Review: The purpose of this paper is to review the epidemiology of obesity and the evolution of artificial sweeteners; to examine the latest research on the effects of artificial sweeteners on the host microbiome, the gut-brain axis, glucose homeostasis, and energy consumption; and to discuss how all of these changes ultimately contribute to obesity.

Recent Findings: Although artificial sweeteners were developed as a sugar substitute to help reduce insulin resistance and obesity, data in both animal models and humans suggest that the effects of artificial sweeteners may contribute to metabolic syndrome and the obesity epidemic. Artificial sweeteners appear to change the host microbiome, lead to decreased satiety, and alter glucose homeostasis, and are associated with increased caloric consumption and weight gain.

Popular Weight Loss Strategies: a Review of Four Weight Loss Techniques.

Purpose Of Review: The purpose of this paper is to review the epidemiology of obesity and the most recent literature on popular fad diets and exercise regimens that are used for weight loss. The weight loss plans that will be discussed in this article include juicing or detoxification diets, intermittent fasting, the paleo diet, and high intensity training.

Recent Findings: Despite the growing popularity of fad diets and exercise plans for weight loss, there are limited studies that actually suggest these particular regimens are beneficial and lead to long-term weight loss.

Statins and Lower Gastrointestinal Conditions: A Retrospective Cohort Study.

Several studies have reported constipation, abdominal pain, or diarrhea as common adverse events for statins. Statins are among the most commonly prescribed medications, and the impact on the prevalence of these conditions was rarely studied as main outcomes. The aim of this study is to determine if statin therapy is associated with constipation, abdominal pain, diarrhea, or colitis.

Safety of Deep Enteroscopy and Capsule Endoscopy in LVAD Patients: Case Report and Literature Review.

Patients with a left ventricular assist device (LVAD) have increased risk of gastrointestinal (GI) bleeding. They are prone to develop angiodysplasia of the small intestine, and have a higher risk of bleeding as these patients are all required to be on permanent therapeutic anticoagulation. Here we report a case of a critically ill 55-year-old male on pressors and inotropes with an LVAD, who successfully underwent an antegrade double balloon enteroscopy (DBE).

A long and distant journey: a case of rectal cancer with metastasis to the orbit.

We present the case of a 33-year-old man with acute onset of eye pain and diplopia as the presenting symptoms of rectal cancer with orbital metastasis. Colorectal cancer with orbital metastasis is exceedingly rare with only 7 cases worldwide despite the prevalence of colorectal cancer. The rarity of this presentation may be related to the long path through multiple vascular beds that tumor emboli from the rectum must travel in order to reach the orbit.

State of the art: treatment of nonalcoholic steatohepatitis.

Purpose Of Review: Nonalcoholic fatty liver disease is the most common cause of chronic liver disease in Western countries, and consists of a spectrum of histopathological changes that range in severity from simple steatosis to steatohepatitis to cirrhosis. The use of pharmacological agents as adjunctive therapy to lifestyle modification is crucial, because weight loss is often difficult to achieve and maintain. The purpose of this review is to analyze the most recent literature pertaining to current therapies for nonalcoholic steatohepatitis (NASH), as there are currently no Food and Drug Administration-approved medications.

Depression proneness and reactions to a depressive stimulus.

In the context of a project examining depression vulnerability and cigarette smoking, the authors tested whether depression-vulnerable people differed from less vulnerable people in their reactions to a depressive stimulus. Regular smokers with a history of depression but not currently depressed (n = 63) and never-depressed smokers (n = 64) listened to audiotapes of confederates reading depressive and nondepressive scripts and reported their reactions. Neither a history of depression nor self-reported depression proneness predicted reactions to depression.

Perceptions of depression among recovered-depressed and never-depressed individuals.

Research on lay beliefs about depression has shown that recovered-depressed people evaluate their own depressive experiences as more distressing than do those who have never experienced major depression. This study tested whether history of depression would influence beliefs about others' experiences of depression. Recovered-depressed (n = 63) and never-depressed adults (n = 64) completed the Self-Appraisal Questionnaire (R-SAQ; J.

Nicotine dependence, PTSD symptoms, and depression proneness among male and female smokers.

Several studies have linked posttraumatic stress disorder with heavy smoking. It is not known to what extent this association is specific, as opposed to being a function of a joint association of PTSD and heavy smoking with a third variable such as depression proneness. In a cross-sectional study of 157 current regular smokers, severity of nicotine dependence (but not cigarettes smoked per day) was positively correlated with total PTSD symptoms, hyperarousal symptoms, and avoidance symptoms.

Facing fears and sadness: cognitive-behavioral therapy for childhood traumatic grief.

The term childhood traumatic grief (CTG) is being increasingly used to refer to the particular reaction in children that may follow the death of a loved one during a traumatic event. The goal of this case study is to describe the theoretical argument and framework for, as well as a clinical example of, cognitive-behavioral therapy (CBT) for CTG. We present a case of a five-year-old boy whose father, a firefighter, died in the line of duty at the World Trade Center on September 11, 2001.

Cognitive coping skills and depression vulnerability among cigarette smokers.

Cigarette smokers vulnerable to depression experience considerable difficulty in quitting smoking, possibly because they use smoking to manage negative affect and possess underdeveloped alternative coping skills for doing so. Efforts to adapt cognitive behavior therapy (CBT) of depression to the treatment of depression-vulnerable smokers have achieved inconsistent results. This research tested one possible explanation for these mixed results, the possibility that depression-vulnerable smokers are not actually deficient in the skills taught in CBT.