דו״ח מאומת

Post-prandial gastrointestinal symptoms such as diarrhea, abdominal distension, flatulence, bloating and a feeling of fullness are common complaints of often unknown etiology and pathogenesis. There is a long history of trials reporting the successful use of products containing a variety of combinations of digestive enzymes including a number of randomized placebo-controlled trials. We provide a narrative review of studies describing the use of multi-digestive enzymes for symptoms consistent with irritable bowel syndrome. We describe clinical trials reported over the past 60 years including double-blinded randomized, placebo-controlled studies and recent trials that focused on post-prandial diarrhea consistent with diarrhea-predominant irritable bowel syndrome. Disaccharidase deficiencies or deficiencies of other carbohydrate digesting enzymes were excluded. Worldwide studies have generally reported success with multi-enzyme preparations although none used a factorial design to identify subgroups or attempted to link specific symptom responses to specific components of therapy. Although there is a long history of the successful use of multi-enzyme preparations for post-prandial symptoms consistent with irritable bowel syndrome, long-term studies using validated scoring systems and factorial designs are needed to confirm the results for specific symptoms and the components of the combination drugs received.…

PMID: 30101562

<h4>Introduction</h4>Abdominal distension is an objective visible sign of increased abdominal girth. Bloating is a feeling of abdominal fullness and discomfort. Bloating may be associated or not with abdominal distension. Bloating and abdominal distension are among the most commonly reported gastrointestinal symptoms and may be associated with both organic and functional disorders. Nevertheless, specific consensus and recommendations on diagnosis, underlying mechanisms, assessment and management of functional bloating and abdominal distension are still lacking. The aim of this European consensus, then, is to provide expert opinions and recommendations on the epidemiology, diagnosis, pathophysiology and treatment of functional bloating and abdominal distension.<h4>Methods</h4>A multidisciplinary team of experts in the field, including European specialists and national societies, participated in the development of this consensus. Relevant questions were formulated and addressed through a literature review and statements were developed and voted using a Delphi process.<h4>Results</h4>Functional bloating and abdominal distension are common and frequently overlap with other disorders of gut-brain interaction. Diagnosis is made according to the Rome IV criteria after the exclusion of organic disease, based on the physical examination and assessment of the patient's medical history and alarming signs. In the absence of alarming signs or any relevant finding, clinical laboratory, imaging or endoscopic tests are unnecessary. The pathophysiology of functional bloating and abdominal distension is multifactorial and involves visceral hypersensitivity, abdomino-phrenic dyssynergia, intestinal dysmotility and dysbiosis. Treatment may include dietary modifications (e.g. lactose-limiting diet and low FODMAP diet), probiotics, antispasmodics (e.g., otilonium bromide, peppermint oil), rifaximin, secretagogues (e.g., linaclotide), neuromodulators (e.g., serotonin-norepinephrine reuptake inhibitors, tricyclic antidepressants, buspirone), and plethysmography-based biofeedback. Moreover, cognitive behaviour therapy and hypnotherapy can be used in case of functional bloating associated with irritable bowel syndrome.<h4>Conclusion</h4>This consensus provides an evidence-based framework for the evaluation and treatment of patients with functional bloating and abdominal distension.…

PMID: 40844856

Food intolerance is an adverse reaction to a particular food or ingredient that may or may not be related to the immune system. A deficiency in digestive enzymes can also cause some types of food intolerances like lactose and gluten intolerance. Food intolerances may cause unpleasant symptoms, including nausea, bloating, abdominal pain, and diarrhea, which usually begin about half an hour after eating or drinking the food in question, but sometimes symptoms may delayed up to 48 h. There is also a strong genetic pattern to food intolerances. Intolerance reactions to food chemicals are mostly dose-related, but also some people are more sensitive than others. Diagnosis can include elimination and challenge testing. Food intolerance can be managed simply by avoiding the particular food from entering the diet. Babies or younger children with lactose intolerance can be given soy milk or hypoallergenic milk formula instead of cow's milk. Adults may be able to tolerate small amounts of troublesome foods, so may need to experiment. Eosinophilic esophagitis (EE) is defined as isolated eosinophilic infiltration in patients with reflux-like symptoms and normal pH studies and whose symptoms are refractory to acid-inhibition therapy. Food allergy, abnormal immunologic response, and autoimmune mechanisms are suggested as possible etiological factors for EE. This article is intended to review the current literature and to present a practical approach for managing food intolerances and EE in childhood.…

PMID: 18594978

Digestive enzymes are found in the digestive tract of animals which assist in the breakdown of larger food molecules into more easily absorbed particles that can then be used by the body. The ability of fish to break down a diet is highly dependent on the availability of suitable digestive enzymes which mediate specific degradation pathways and on both the physical and chemical nature of food. Probiotics are known to produce helpful enzymes that aid in digestion and protect the gastrointestinal tract (GIT) of animals. When applied appropriately, probiotics improve intestinal microbial balance which also improves digestive enzyme activities, food absorption, and decrease pathogenic issues in the GIT. They work hand-in-hand with the digestive enzymes in the GIT of animals as supplements thereby improvings nutrition. This in turn leads to higher feed efficiency and growth as well as the prevention of antinutritional factors present in the ingredients, intestinal disorders, and pre-digestion. This review seeks to present summaries of the results of research findings on the application of probiotics on the activities of digestive enzymes including amylase, lipase, and protease. Further, this review points out gaps in available literature and suggests ideas that could be explored in further investigations to better understand and enhance the activities of these digestive enzymes to increase feed and nutrient utilization and the production of aquaculture species.…

PMID: 34343669

The study of proteolysis of plant proteins is attracting increasing attention. When proteolytic enzymes act on plant proteins, peptides with different biological activities can be released. Proteolytic hydrolysis, being a natural mechanism of protein digestion in the body, has been successfully adapted for use in food technology in order to modify the functional and biological properties of protein ingredients. The purpose of this work was to study the effect of digestive enzymes on soy protein in vitro and analyze the peptide profile of the obtained hydrolysates using in silico instruments.<h4>Material and methods</h4>The proteolysis of soy protein isolate (with a protein content of 89%) was carried out using the enzymes trypsin (at pH 7.8±0.1), pepsin (at pH 2.0±0.1), as well as their sequential action - hydrolysis first with pepsin (for 2 hours), and then with trypsin (2 hours). The degree of hydrolysis was calculated as the ratio of the concentration of amine nitrogen released during proteolysis to the total nitrogen content in the suspension before hydrolysis. The dominant peptides were identified using the nano- LC-MS/MS method. The databases BIOPEP-UWM, AntiBP3, Antifp, AntiCP 2.0, and AntiTbPred were used to predict the biological activity of the dominant peptide sequences in hydrolysates. The toxicity of the peptides was assessed using ToxinPred3.0. AutoDock Vina 1.2.7 software was used for molecular docking.<h4>Results</h4>When treated with trypsin (200 U/g) at an enzyme dosage of 4% for 4 hours, the degree of hydrolysis was 5.38%, when treated with pepsin (420 U/g) at the same enzyme dosage for 4 hours, taking into account optimal pH values, the degree of hydrolysis was 7.06%. With sequential proteolysis by these enzymes, a hydrolysis rate of 7.71% was achieved. Based on mass spectrometric data, 37 of the most common peptide sequences present in hydrolysates were analyzed in silico. The dominant properties predicted for the discovered peptide sequences were the ability to inhibit angiotensin-converting enzyme (ACE) and dipeptidyl peptidase IV (DPP-IV), as well as oncostatic properties. The binding energy of some peptides to DPP-IV and ACE enzymes was also estimated using molecular docking. A low binding energy to DPP-IV (-8.154 kcal/mol) was observed in the ATISDQPRGSY peptide, while the LAIPVNKPGRF, TTVPPHSVQVHTTTHRYEAGVPPARF and VSIIDTNSLENQLDQMPRRF peptides had a low binding index to ACE (<-8.5 kcal/mol), indicating a potentially high inhibitory activity of these peptides against DPP-IV and ACE.<h4>Conclusion</h4>The present study describes a number of new bioactive peptides from soy that can be formed during proteolysis by pepsin and trypsin. The data obtained form the basis for further investigation of the biological activity of the obtained hydrolysates and the identified peptides, which in the future may be useful for the development of technologies for functional products and components from soy protein. Another area of further research (in view of the origin of the enzymes under study) may be the search for identified peptides in conditions close to human digestion, which will expand knowledge about the mechanisms of the physiological effect of soy protein when consumed. It is advisable to direct further research to the chemical synthesis of the peptides found in this research in order to study their properties in vitro and in vivo.…

PMID: 42272414