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Background: Irritable bowel syndrome (IBS) is a prevalent functional disorder of the gastrointestinal tract that affects approximately 11% of people worldwide. The exact mechanisms underlying IBS remain unclear, but evidence suggests that low-grade inflammation is involved in its pathophysiology. Interleukin-6 (IL-6) is a key cytokine that mediates inflammatory responses in the intestinal mucosa and has been linked to the development of IBS. Our study aimed to provide an overview of the current knowledge on the role of IL-6 in IBS. Materials and Methods: The present study was conducted based on a search on the PubMed database, where only 26 articles investigated the role of IL-6 in irritable bowel syndrome were found. Results: Our review revealed that patients with IBS had higher levels of IL-6 in their serum/plasma. Furthermore, increased expression of IL-6 mediated by cholinergic signalling was associated with increased abdominal pain/discomfort and bloating. More recently, an interaction between IL-6 and corticotrophin-releasing factor was shown to provide more insight into the mechanisms underlying IBS symptoms during stressful periods, which are experienced by almost two-thirds of patients with IBS. Elevated levels of IL-6 were also correlated with increased fatigue and intestinal inflammation. Targeting IL-6 expression or IL-6 signalling pathway using probiotics, vitamin D3 or a replacement diet may offer a novel therapeutic strategy to improve IBS symptoms, abdominal pain, bloating and fatigue after consumption of ancient wheat products. Conclusion: Further studies are needed to elucidate the causal relationship between IL-6 and IBS, as well as the molecular pathways and cellular targets of IL-6 in the gut. [ABSTRACT FROM AUTHOR]

Background. One of the effective genes in the pathogenesis of the celiac disease is the Ets1 gene, which encodes the transcription factor Ets1 and is highly conserved during evolution. The Ets1 gene inhibits the differentiation of T helper 17 (Th17) cells and the production of interleukin-17A (IL-17A) by these cells and decreased expression of the Ets1 gene can lead to autoimmune disorders. The aim of this study is to evaluate the changes in Ets1 gene expression in the blood samples of patients with celiac disease compared with the control group. Methods. Blood samples were collected from twenty patients with celiac disease under a gluten-free diet and also from twenty healthy people. After RNA extraction and cDNA synthesis, a specific primer pair of the Ets1 gene was designed and its expression changes were examined by real-time PCR. Results. The expression of the Ets1 gene in patients with celiac disease on a gluten-free diet did not show a significant difference compared with healthy individuals (P-value= 0.54).. Conclusion. Failure to observe a significant difference between the patient and the control group can be due to the effect of the duration of the gluten-free diet and also the inadvertent entry of gluten from hidden sources into the diet of patients under treatment. Practical Implications. According to the results observed in this study, it is possible that if the gluten-free diet is followed more strictly and over a longer period of time by patients with celiac disease, the expression of the Ets1 gene will proceed as we expected. This issue needs to be evaluated in future studies with a larger community. [ABSTRACT FROM AUTHOR]

Background: Mental and physiological responses to the repeated use of drugs are called dependency. Opioid bowel dysfunction (OBD) is common side effect associated with opium. OBD has many manifestations such as abdominal pain, abdominal cramping, bloating and gastroesophageal reflux but is known commonly by constipation. Narcotic bowel syndrome (NBS) is a subset of OBD characterized by recurrent and chronic abdominal pain getting worse by continuing or increasing doses of opium. Due to ever increasing incidence of consumption of narcotics drugs and also expanded spread of gastrointestinal disorders in people of society and due to lack of precise studies in such cases in Iran, research in this field seemed vital. Methods: In this cross-sectional study, among all methadone maintenance therapy (MMT) clinics in Isfahan, Iran, 4 centers were selected by easy non-probability sampling method in 2012 fall. A questionnaire was distributed among the opioid consumers. The questionnaire contained demographic information sucs as age, sex, occupation, and duration of drug use, drug type, duration of MMT, gastrointestinal symptoms and the severity of the symptoms. Findings: From 192 completed and collected questionnaires, 184 were acceptable. The most common gastrointestinal symptoms in patients were constipation, abdominal pain, belching and bad taste in the mouth, respectively. The severity of symptoms and extent of methadone use in patients were assessed and gastrointestinal symptoms were not associated significantly with methadone dose of patients. Conclusion: In this study, the prevalence of gastrointestinal symptoms among patients in addiction clinics was assessed and the most common digestive complaint of these patients was constipation. Severity of constipation and other gastrointestinal symptoms were unrelated with amount of methadone use and the type and amount of prior drug use. [ABSTRACT FROM AUTHOR]

Background: The current treatment of IBS is often unsatisfactory and frustrating. Several controlled trials have demonstrated benefits of tricyclic antidepressants for irritable bowel syndrome, especially when pain is a prominent symptom but the efficacy of antidepressants in irritable bowel syndrome is controversial. The aim of this study was to compare the effect of doxepin and nortriptyline on diarrhea-predominant irritable bowel syndrome. Methods: Seventy-five patients with IBS according to Rome III criteria were treated for two months. The patients were randomly assigned to one of three groups treated with doxepin, nortriptyline or placebo. Subjects were assessed clinically one month and two months after treatment. The symptoms and adverse effects of the drugs were recorded in the questionnaire. The total score was considered as the number of the symptoms for each patient, which ranged between zero and six. Results: Improvements in abdominal pain and bloating in the doxepin group were significantly higher than the nortriptyline or the placebo groups (P=0.001 and P=0.012, respectively). However, improvement in diarrhea in patients on nortriptyline was significantly higher than the other groups (P=0.018). The average improvement of symptoms in the patients after two months of treatment in doxepin, nortriptyline and placebo groups, respectively were 2.56, 2 and 0.6 (P<0.05). Conclusion: Both doxepin and nortriptyline are effective for the treatment of diarrheapredominant irritable bowel syndrome in a period of two months but doxepin seems to be more efficacious than nortriptyline in this regard. However, larger comparative trials are suggested. [ABSTRACT FROM AUTHOR]

Background: The presence of foam/bubbles in stomach and duodenum is a common problem during esophagogastroduodenoscopy (EGD) that interferes with precise evaluation of the mucosa. We evaluated the effectiveness of simethicone in reducing foam/bubbles in stomach and duodenum, endoscopy duration, and patient satisfaction. Methods: This double-blind, randomized, placebo-controlled trial was conducted on candidates for elective EGD referring to Poursina Hakim Clinic, Isfahan (Iran). Participants received 40 mg chewable tablet of simethicone or placebo, with 30 ml water, 15-30 minutes before the EGD. Foam/bubbles during endoscopy were assessed and graded by a single endoscopist from 0 to 3 and the endoscopy duration was recorded. Patient's satisfaction was scored from 0 to 10. Findings: During the study, 90 and 83 patients were entered into the simethicone and placebo groups, respectively. Degree of foam/bubbles was significantly less in simethicone compared to placebo group (P = 0.002). No difference was found between the two groups in foam/bubbles of duodenum (P > 0.05). Duration of endoscopy was, on average, one minute shorter in simethicone compared with placebo group (P < 0.001). Patient's satisfaction was similar between the two groups. No adverse effect was observed from simethicone. Conclusion: Simethicone before EGD significantly reduce the foam/bubbles in stomach and provide better visibility for evaluating the mucosa, and also decrease the duration of endoscopy. Accordingly, routine administration of simethicone for preparation before EGD is recommended. [ABSTRACT FROM AUTHOR]