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Choosing the right drug

Maura Corsetti 1

Affiliations

1 University of Nottingham, Nottingham, United Kingdom

Summary

AI Generated

The speaker reviewed evidence suggesting that several medications used for chronic constipation may be effective in patients with functional defecatory disorder, challenging the view that only non-pharmacological approaches are appropriate.

Pivotal trials for PEG, bisacodyl, picosulfate, and prucalopride did not exclude patients with defecatory disorder, and the speaker reported that prucalopride showed improvement in symptoms including incomplete bowel movement, straining, and hard stools.
The speaker stated that a study over 20 years ago found bisacodyl suppository increased rectal tone and was effective in patients with obstructed defecation but not in those with delayed transit.
In the speaker's unpublished study in healthy subjects, prucalopride was the only agent that reduced rectal compliance and sensitized the rectum compared to picosulfate and placebo.
Linaclotide trials showed similar results regardless of whether patients with pelvic floor dysfunction were excluded, suggesting the speaker believes it may work in patients with and without defecatory disorder.
The speaker recommended considering amitriptyline for patients with rectal hypersensitivity, citing a study showing it reduced rectal pain activation in the brain.

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Abstract

Event

UEG Week Vienna 2024

Topics

Colorectal Primary Care Surgery

Session

A topic we don't talk about: Evacuation disorders

Citation

United European Gastroenterology Journal 2024; 12 (Supplement 8)

Published

2024

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BLOATING AND VISIBLE ABDOMINAL DISTENSION IN IRRITABLE BOWEL SYNDROME AND FUNCTIONAL DYSPEPSIA: OVERLAPPING OR DISTINCT SYMPTOMS?

Magnus Simrén

Chronic constipation (Complete Session)

Therapeutic approach to DGBI: Drugs or diet?

Magnus Simrén

IMPROVEMENT IN INTESTINAL IMMUNE ACTIVATION, PERMEABILITY AND SENSITIVITY WITH LOCAL BUDESONIDE IN A VALIDATED MODEL FOR DISORDERS OF GUT-BRAIN INTERACTION

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Gut-brain chaos: Here’s how primary care can restore order

Christos D Lionis

NON-CELIAC WHEAT SENSITIVITY IN REFRACTORY FUNCTIONAL DYSPEPSIA AND IRRITABLE BOWEL SYNDROME: A PROSPECTIVE, RANDOMIZED STUDY

Ajit Sood

UEG Presentation

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BLOATING AND VISIBLE ABDOMINAL DISTENSION IN IRRITABLE BOWEL SYNDROME AND FUNCTIONAL DYSPEPSIA: OVERLAPPING OR DISTINCT SYMPTOMS?

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BLOATING AND VISIBLE ABDOMINAL DISTENSION IN IRRITABLE BOWEL SYNDROME AND FUNCTIONAL DYSPEPSIA: OVERLAPPING OR DISTINCT SYMPTOMS?

Tom van Gils 1, Ryo Katsumata 1, Jóhann Hreinsson 1, Douglas Drossman 2, Jan Tack 3, Hans Törnblom 1, Boris Le Nevé 4, Laurent Quinquis 4, Rim Hassouna 4, Max Julio Schmulson Wasserman 5, Shrikant I. Bangdiwala 6, Olafur S. Palsson 7, Magnus Simrén 8

Affiliations

1 University of Gothenburg, Gothenburg, Sweden

2 University of North Carolina/Chapel Hill, Chapel Hill, United States|||The Rome Foundation, Raleigh, United States

3 University of Gothenburg, Gothenburg, Sweden|||University of Leuven, University Hospital Gasthuisberg, Leuven, Belgium

4 Danone Global Research & Innovation, Gif-sur-Yvette, France

5 Universidad Nacional Autónoma de México, Mexico City, Mexico

6 McMaster University, Hamilton, Canada

7 University of North Carolina/Chapel Hill, Chapel Hill, United States

8 University of Gothenburg, Gothenburg, Sweden|||University of North Carolina/Chapel Hill, Chapel Hill, United States

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Abstract

Introduction

Irritable bowel syndrome (IBS) and functional dyspepsia (FD) are common disorders of gut-brain interaction (DGBI), and bloating and visible abdominal distension are common symptoms among individuals with IBS and/or FD. Bloating refers to a subjective sensation of tension or pressure in the abdomen, which may or may not be reported together with visible abdominal distension. The underlying pathophysiological mechanisms may differ, with bloating suggested to be more related to hypersensitivity and visible abdominal distension to altered motility. The prevalence of these two symptoms in IBS and FD, especially as distinct symptoms, is not well known.

Aims & Methods

The aim was to investigate the link between bloating and distension with IBS and FD. Therefore, we performed a population-based internet survey of adults in the US, UK, and Mexico, including Rome IV IBS and FD diagnostic questions, somatization (PHQ-12), and psychological distress (PHQ-4). Four groups were created: those meeting the Rome IV criteria for IBS only, FD only, both IBS+FD, and a reference group including individuals without IBS, FD and organic diagnoses that could result in IBS- or FD-like symptoms. Within each group, we identified individuals who reported ≥weekly bloating alone (B), ≥weekly visible abdominal distension alone (D), ≥weekly combined B+D, or neither of both. The relationship between B, D and B+D in those with IBS and/or FD vs. the reference group was investigated using logistic regression models.

Results

The analysis included 5,448 participants (49.7% female; mean age 46.5 years, range 18-99), with 131 meeting criteria for IBS only, 360 for FD only, 217 for IBS+FD and 4,740 for the reference group. A larger proportion of individuals with IBS only (64.9%), FD only (50.6%), and especially those with IBS+FD (88.5%) reported bloating and/or visible abdominal distension compared to the reference group (13.7%). In the IBS only group, 16.0% reported bloating alone, 8.4% visible abdominal distension alone, and 40.5% combined bloating and visible abdominal distension. In the FD only group this was 12.8% (B), 8.9% (D), and 28.9% (B+D), and in the IBS+FD group 18.9% (B), 8.3% (D), and 61.3% (B+D), respectively. Reporting bloating alone or combined bloating and visible abdominal distension was strongly linked to fulfilling criteria for IBS only, FD only, and concomitant IBS+FD vs. the reference group, with weaker links for visible abdominal distension in the absence of bloating (Table). After adjusting for age, sex, BMI, psychological distress and somatization, the links persisted. The strongest association was observed between combined bloating and visible abdominal distension (vs. neither) and concomitant IBS+FD (vs. the reference group); adjusted odds ratio 28.6 [95%CI 17.6-46.6].

	IBS without FD vs. reference group Crude OR [95%]	FD without IBS vs. reference group Crude OR [95%CI]	IBS+FD vs. reference group Crude OR [95%CI]
Bloating alone^a	13.7 [8.0-23.6]	7.8 [5.4-11.2]	49.3 [29.1-83.4]
Visible abdominal distension alone^a	5.0 [2.5-9.7]	3.7 [2.5-5.6]	14.9 [8.0-27.9]
Combined bloating and visible abdominal distension^a	14.8 [9.8-22.3]	7.5 [5.8-9.8]	68.4 [44.0-106.5]
	IBS without FD vs. reference group Adjusted OR [95%]^b	FD without IBS vs. reference group Adjusted OR [95%]^b	IBS+FD vs. reference group Adjusted OR [95%]^b
Bloating alone^a	8.5 [4.6-15.5]	4.8 [3.1-7.2]	25.6 [14.5-45.1]
Visible abdominal distension alone^a	3.9 [1.9-7.9]	2.9 [1.9-4.5]	9.3 [4.9-17.9]
Combined bloating and visible abdominal distension^a	8.4 [5.1-13.6]	4.4 [3.2-6.0]	28.6 [17.6-46.6]
Table. Link between bloating and/or visible abdominal distension and IBS and FD ^a ≥weekly bloating and/or visible distension vs. <weekly bloating and distension or neither of both. ^b odds ratio based on logistic regression models, adjusted for age, sex, BMI, psychological distress (PHQ-4), and somatization (PHQ-12).

Conclusion

Bloating and visible abdominal distension as distinct and overlapping symptoms are strongly linked to IBS, FD, and concomitant IBS+FD in the general population. Assessing bloating and visible abdominal distension as separate symptoms may be important to enable individualized treatment for individuals with IBS and FD.

Event

UEG Week Berlin 2025

Topics

Neurogastroenterology & Motility Colorectal

Submission format

Abstract

Session

Lower GI motility I

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Magnus Simrén

Chronic constipation (Complete Session)

Therapeutic approach to DGBI: Drugs or diet?

Magnus Simrén

IMPROVEMENT IN INTESTINAL IMMUNE ACTIVATION, PERMEABILITY AND SENSITIVITY WITH LOCAL BUDESONIDE IN A VALIDATED MODEL FOR DISORDERS OF GUT-BRAIN INTERACTION

Tim Vanuytsel

Gut-brain chaos: Here’s how primary care can restore order

Christos D Lionis

NON-CELIAC WHEAT SENSITIVITY IN REFRACTORY FUNCTIONAL DYSPEPSIA AND IRRITABLE BOWEL SYNDROME: A PROSPECTIVE, RANDOMIZED STUDY

Ajit Sood

UEG Presentation

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Chronic constipation (Complete Session)

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Abstract

Event

UEG Week Berlin 2025

Topics

Primary Care

Session

Chronic constipation

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

More Like This:

BLOATING AND VISIBLE ABDOMINAL DISTENSION IN IRRITABLE BOWEL SYNDROME AND FUNCTIONAL DYSPEPSIA: OVERLAPPING OR DISTINCT SYMPTOMS?

Magnus Simrén

Chronic constipation (Complete Session)

Therapeutic approach to DGBI: Drugs or diet?

Magnus Simrén

IMPROVEMENT IN INTESTINAL IMMUNE ACTIVATION, PERMEABILITY AND SENSITIVITY WITH LOCAL BUDESONIDE IN A VALIDATED MODEL FOR DISORDERS OF GUT-BRAIN INTERACTION

Tim Vanuytsel

Gut-brain chaos: Here’s how primary care can restore order

Christos D Lionis

NON-CELIAC WHEAT SENSITIVITY IN REFRACTORY FUNCTIONAL DYSPEPSIA AND IRRITABLE BOWEL SYNDROME: A PROSPECTIVE, RANDOMIZED STUDY

Ajit Sood

UEG Presentation

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

Therapeutic approach to DGBI: Drugs or diet?

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Therapeutic approach to DGBI: Drugs or diet?

Magnus Simrén 1

Affiliations

1 Sahlgrenska University Hospital - Dept of Internal Medicine, Sahlgrenska University Hospital ; Gothe, Gothenburg, Sweden

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Abstract

Event

UEG Week Berlin 2025

Topics

Neurogastroenterology & Motility Small Intestine & Nutrition Primary Care

Session

Disorders of gut‐brain interaction: Dietary restrictions

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

More Like This:

BLOATING AND VISIBLE ABDOMINAL DISTENSION IN IRRITABLE BOWEL SYNDROME AND FUNCTIONAL DYSPEPSIA: OVERLAPPING OR DISTINCT SYMPTOMS?

Magnus Simrén

Chronic constipation (Complete Session)

Therapeutic approach to DGBI: Drugs or diet?

Magnus Simrén

IMPROVEMENT IN INTESTINAL IMMUNE ACTIVATION, PERMEABILITY AND SENSITIVITY WITH LOCAL BUDESONIDE IN A VALIDATED MODEL FOR DISORDERS OF GUT-BRAIN INTERACTION

Tim Vanuytsel

Gut-brain chaos: Here’s how primary care can restore order

Christos D Lionis

NON-CELIAC WHEAT SENSITIVITY IN REFRACTORY FUNCTIONAL DYSPEPSIA AND IRRITABLE BOWEL SYNDROME: A PROSPECTIVE, RANDOMIZED STUDY

Ajit Sood

UEG Presentation

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

IMPROVEMENT IN INTESTINAL IMMUNE ACTIVATION, PERMEABILITY AND SENSITIVITY WITH LOCAL BUDESONIDE IN A VALIDATED MODEL FOR DISORDERS OF GUT-BRAIN INTERACTION

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IMPROVEMENT IN INTESTINAL IMMUNE ACTIVATION, PERMEABILITY AND SENSITIVITY WITH LOCAL BUDESONIDE IN A VALIDATED MODEL FOR DISORDERS OF GUT-BRAIN INTERACTION

Pauline Huyghe 1, Alison Accarie 1, Mathieu Meleine 1, Karen Van den Houte 1, Joran Toth 1, Lucas Wauters 2, Jan Tack 2, Ricard Farré 1, Tim Vanuytsel 2

Affiliations

1 KU Leuven, Leuven, Belgium

2 University of Leuven, University Hospital Gasthuisberg, Leuven, Belgium|||KU Leuven, Leuven, Belgium

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Abstract

Introduction

Disorders of gut-brain interaction (DGBIs), such as functional dyspepsia and irritable bowel syndrome, are chronic gastrointestinal disorders with recurrent and bothersome abdominal symptoms. Although incompletely understood, immune activation, particularly involving eosinophils and mast cells, and visceral hypersensitivity have been implicated in their pathophysiology.

Aims & Methods

Using the normoglycemic Biobreeding diabetes-prone (BBDP-N) rat, we aim to 1) characterise the immune activation in jejunal and colonic mucosa and to 2) study the effect of budesonide, a local anti-inflammatory corticosteroid, on gut physiology and sensitivity.
90-day-old BBDP-N and Biobreeding diabetes-resistant (control) rats underwent a 28-day treatment with budesonide (0.5 mg/kg/day) or vehicle. Eosinophils and mast cells were identified by staining jejunal and colonic sections with Chromotrope 2R and anti-mast cell protease 2 antibody, respectively. To assess their activity, eosinophil peroxidase (EPO) and β-hexosaminidase levels were measured. Jejunal and colonic segments were mounted in modified Ussing chambers, and permeability was assessed by the transmucosal passage of a fluorescently labelled 20 and 4kDa dextran molecule (FITC-Dx4/20), and the transepithelial electrical resistance (TEER). Sensitivity to isobaric colorectal distension was assessed(1): the ∆ area under the curve (AUC) of the visceromotor response (VMR) to wall tension was calculated at baseline and after treatment. Depending on the normality of the data, an unpaired t-test or Mann-Whitney test was performed.

Results

Comparing vehicle-treated groups, the BBDP-N rats had higher numbers of jejunal eosinophils (1366.0±201.3 vs. 561.7±55.3 eosinophils/mm²; p<0.01) and mast cells (1151.0±136.7 vs. 549.1±44.8 mast cells/mm²; p<0.001), whereas only colonic eosinophil numbers were higher (222.7±40.4 vs. 128.9±14.5 eosinophils/mm²; p=0.03). Additionally, EPO levels were higher in the BBDP-N rats in both regions (jejunum: 59.4±9.8 vs. 4.4±3.0 µg/g tissue; p<0.01 & colon: 82.0±23.6 vs. 1.6±1.1 µg/g tissue; p<0.01), with no difference in mast cell activation. Following budesonide treatment, eosinophil (jejunum, BBDP-N: 167.3±53.6 vs. 1366.0±201.3 eosinophils/mm²; p<0.001 & control: 220.1±43.7 vs. 561.7±55.3 eosinophils/mm²; p<0.01, colon: BBDP-N: 58.2±11.9 vs. 222.7±40.4 eosinophils/mm²; p<0.01 & control: 78.1±14.4 vs. 128.9±14.5 eosinophils/mm²; p=0.01) and mast cell (jejunum: BBDP-N: 418.8±51.0 vs. 1151.0±136.7 mast cells/mm²; p<0.001 & control: 305.4±67.6 vs. 549.1±44.8 mast cells/mm²; p=0.01, colon: BBDP-N: 146.5±19.1 vs. 262.6±37.5 mast cells/mm²; p<0.01 & control: 137.4±17.8 vs. 244.9±29.4 mast cells/mm²; p<0.01) levels decreased in both groups in both regions. Colonic eosinophil activation was also reduced in BBDP-N rats (21.5±9.7 vs. 82.0±23.6 µg/g tissue; p=0.05), with no effect on mast cell activation. Jejunal permeability, assessed by 20kDa passage was increased in vehicle-treated BBDP-N rats (258.0±51.5 vs. 132.0±25.1 pmol/cm²; p=0.03). Budesonide treatment significantly increased colonic TEER in BBDP-N rats (73.2±4.3 vs. 38.3±4.1 Ω.cm²; p<0.001). Colonic sensitivity to distention was significantly reduced in BBDP-N following the treatment (-20.1±17.2 vs. 207.0±85.5 mV/s x mmHg.cm; p=0.02).

Conclusion

In conclusion, our work shows the importance of eosinophil and mast cell predominant immune activation in visceral hypersensitivity in a well-characterised preclinical model of DGBI. Anti-inflammatory treatments should be re-evaluated in DGBI with intestinal eosinophil and mast cell infiltration.

References

1: Meleine M et al. Neurogastroenterology and motility, 2019.

Event

UEG Week Berlin 2025

Topics

Immunology Neurogastroenterology & Motility Small Intestine & Nutrition Oesophagus Stomach & H. Pylori

Submission format

Abstract

Session

Complexity and diversity in upper GI

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

More Like This:

BLOATING AND VISIBLE ABDOMINAL DISTENSION IN IRRITABLE BOWEL SYNDROME AND FUNCTIONAL DYSPEPSIA: OVERLAPPING OR DISTINCT SYMPTOMS?

Magnus Simrén

Chronic constipation (Complete Session)

Therapeutic approach to DGBI: Drugs or diet?

Magnus Simrén

IMPROVEMENT IN INTESTINAL IMMUNE ACTIVATION, PERMEABILITY AND SENSITIVITY WITH LOCAL BUDESONIDE IN A VALIDATED MODEL FOR DISORDERS OF GUT-BRAIN INTERACTION

Tim Vanuytsel

Gut-brain chaos: Here’s how primary care can restore order

Christos D Lionis

NON-CELIAC WHEAT SENSITIVITY IN REFRACTORY FUNCTIONAL DYSPEPSIA AND IRRITABLE BOWEL SYNDROME: A PROSPECTIVE, RANDOMIZED STUDY

Ajit Sood

UEG Presentation

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Gut-brain chaos: Here’s how primary care can restore order

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Gut-brain chaos: Here’s how primary care can restore order

Christos D Lionis 1

Affiliations

1 University of Crete, Heraklion, Greece

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Abstract

Event

UEG Week Berlin 2025

Topics

Neurogastroenterology & Motility Paediatrics Standards & Guidelines Stomach & H. Pylori

Session

From guidelines to clinical practice: The gut-brain connection - PPIs and guideline application in clinical practice

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

More Like This:

BLOATING AND VISIBLE ABDOMINAL DISTENSION IN IRRITABLE BOWEL SYNDROME AND FUNCTIONAL DYSPEPSIA: OVERLAPPING OR DISTINCT SYMPTOMS?

Magnus Simrén

Chronic constipation (Complete Session)

Therapeutic approach to DGBI: Drugs or diet?

Magnus Simrén

IMPROVEMENT IN INTESTINAL IMMUNE ACTIVATION, PERMEABILITY AND SENSITIVITY WITH LOCAL BUDESONIDE IN A VALIDATED MODEL FOR DISORDERS OF GUT-BRAIN INTERACTION

Tim Vanuytsel

Gut-brain chaos: Here’s how primary care can restore order

Christos D Lionis

NON-CELIAC WHEAT SENSITIVITY IN REFRACTORY FUNCTIONAL DYSPEPSIA AND IRRITABLE BOWEL SYNDROME: A PROSPECTIVE, RANDOMIZED STUDY

Ajit Sood

UEG Presentation

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

NON-CELIAC WHEAT SENSITIVITY IN REFRACTORY FUNCTIONAL DYSPEPSIA AND IRRITABLE BOWEL SYNDROME: A PROSPECTIVE, RANDOMIZED STUDY

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

NON-CELIAC WHEAT SENSITIVITY IN REFRACTORY FUNCTIONAL DYSPEPSIA AND IRRITABLE BOWEL SYNDROME: A PROSPECTIVE, RANDOMIZED STUDY

Omesh Goyal 1, Manjeet Kumar Goyal 2, Prerna Goyal 3, Paraag Kumar 4, Ajit Sood 1

Affiliations

1 Dayanand Medical College and Hospital, Ludhiana, India

2 All India Institute of Medical Sciences, New Delhi, New Delhi, India

3 R.G. stone and superspeciality Hospital, Ludhiana, India

4 Maharishi Markandeshwar Institute of Medical Sciences and Research, Ambala, India

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Abstract

Introduction

Non-celiac gluten/wheat sensitivity (NCGWS) is characterized by gastrointestinal and extra-intestinal symptoms triggered by gluten/wheat ingestion. Symptoms of NCGWS overlap with those of irritable bowel syndrome (IBS) or functional dyspepsia (FD). Due to diagnostic challenges and symptom overlap, data on the prevalence and predictors of NCGWS among patients with IBS or FD, especially those with refractory symptoms, are limited.

Aims & Methods

This was a prospective, multicentric, double-blind, placebo-controlled, crossover trial conducted from October 2021 to March 2023 in India.This was prospectivly registered with the clinical trials Registry, INDIA (CTRI/2021/10/037323). Adults aged 18–65 years with Rome IV-defined irritable bowel syndrome (IBS) or functional dyspepsia (FD) refractory to standard treatment were enrolled after excluding celiac disease, wheat allergy, and alarm features. Participants underwent a two-step diagnostic protocol. In Step I, patients adhered to a 6-week strict gluten-free diet (GFD) under dietitian supervision. Weekly assessments of gastrointestinal and extra-intestinal symptoms, health-related quality of life (HRQoL), and psychological scores were performed using validated instruments. Gluten responders—defined by ≥30% reduction in one to three primary symptoms—were advanced to Step II: a randomized, double-blind, placebo-controlled gluten challenge with crossover. Subjects received indistinguishable gluten or placebo cookies (8 g/day) for one week, followed by a one-week washout and crossover. A ≥30% symptom difference between gluten and placebo phases confirmed non-celiac gluten/wheat sensitivity (NCGWS). Primary outcome was NCGWS prevalence; secondary outcomes included symptom and HRQoL changes post-GFD and predictors of NCGWS. Statistical analyses included intention-to-treat principles and multivariable regression to identify baseline predictors.

Results

Of the 252 patients screened, 177 were enrolled for 6-week GFD (step I), and 154 patients completed this phase (mean age 41.9±14.2 years, 53.2% males). Eighty two (52.3%) patients responded to GFD, of whom 77 entered step 2 (DBPCGC). Thirty one (20.1%) patients had significant symptom worsening on blinded gluten ingestion, suggesting the presence of NCGWS. Independent predictors of NCGWS were female gender, FD-IBS overlap, headache, fatigue, and anxiety. Significant improvements in gastrointestinal symptoms, health-related quality of life, and psychological scores were observed after GFD in responders. No significant impact of diet sequence was noted.

Variable	Univariable regression	Multivariable regression
Variable	OR (95% CI)	p value	OR (95% CI)	p value
Female gender	1.661 (1.236–2.261)	< 0.001	1.519 (1.041–2.036)	0.028
Abdominal pain	0.354 (0.081–1.422)	0.451
Abnormal stool consistency	1.238 (1.033–1.521)	0.004	1.334 (1.022–2.551)	0.512
Bloating	1.433 (1.073–3.571)	0.031	0.889 (0.541–2.391)	0.093
Dyspepsia - Irritable bowel syndrome Overlap	4.442 (1.613–9.441)	< 0.001	2.056 (1.131–3.031)	0.031
Headache	2.117 (1.028–5.516)	0.029	0.615 (0.315–1.318)	0.044
Fatigue	4.117 (2.027–8.134)	< 0.001	1.073 (1.022–1.191)	0.012
Anxiety	2.724 (1.033–5.769)	0.018	1.992 (1.741–2.014)	0.037

Conclusion

Approximately one-fifth of patients with refractory IBS or FD were diagnosed with non-celiac gluten/wheat sensitivity (NCGWS) using a structured double-blind, placebo-controlled gluten challenge. Identification of NCGWS is essential to avoid unnecessary pharmacotherapy and to enable targeted dietary interventions. A gluten-free diet significantly improved gastrointestinal and extra-intestinal symptoms, as well as quality of life, highlighting the need for precise diagnostic strategies in clinical practice.

Event

UEG Week Berlin 2025

Topics

Immunology Neurogastroenterology & Motility Small Intestine & Nutrition Oesophagus Stomach & H. Pylori

Submission format

Abstract

Session

Complexity and diversity in upper GI

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

More Like This:

BLOATING AND VISIBLE ABDOMINAL DISTENSION IN IRRITABLE BOWEL SYNDROME AND FUNCTIONAL DYSPEPSIA: OVERLAPPING OR DISTINCT SYMPTOMS?

Magnus Simrén

Chronic constipation (Complete Session)

Therapeutic approach to DGBI: Drugs or diet?

Magnus Simrén

IMPROVEMENT IN INTESTINAL IMMUNE ACTIVATION, PERMEABILITY AND SENSITIVITY WITH LOCAL BUDESONIDE IN A VALIDATED MODEL FOR DISORDERS OF GUT-BRAIN INTERACTION

Tim Vanuytsel

Gut-brain chaos: Here’s how primary care can restore order

Christos D Lionis

NON-CELIAC WHEAT SENSITIVITY IN REFRACTORY FUNCTIONAL DYSPEPSIA AND IRRITABLE BOWEL SYNDROME: A PROSPECTIVE, RANDOMIZED STUDY

Ajit Sood

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