Un desdejuni calòric disminueix la satisfacció después d'esmorzar a mig matí

Un estudi del Departament de Medicina de la UAB i l'Hospital Universitari Vall d'Hebron ha analitzat l'efecte de la quantitat de calories ingerides durant el desdejuni, a primera hora del matí, a la satisfacció i sensació de benestar en prendre un petit esmorzar dues hores després. Com més calòric és el primer àpat, menys es gaudeix del segon.Un estudio del Departamento de Medicina de la UAB y el Hospital Universitario Vall d'Hebron ha analizado el efecto de la cantidad de calorías ingeridas durante el desayuno en la satisfacción y sensación de bienestar al tomar un pequeño almuerzo dos horas después. Cuanto más calórico es el desayuno, menos se disfruta del almuerzo.A study conducted by the UAB Department of Medicine and the Vall d'Hebron University Hospital analyses the effects a high-calorie breakfast early in the morning has on the satifaction and sense of well-being after eating a mid-morning snack two hours later. More breakfast calories results in less enjoyment when eating the snack

Gastrointestinal Contributions to the Postprandial Experience

Foodingestion induces homeostatic sensations (satiety, fullness) with a hedonic dimension (satisfaction, changes in mood) that characterize the postprandial experience. Both types of sensation are secondary to intraluminal stimuli produced by the food itself, as well as to the activity of the digestive tract. Postprandial sensations also depend on the nutrient composition of the meal and on colonic fermentation of non-absorbed residues. Gastrointestinal function and the sensitivity of the digestive tract, i.e., perception of gut stimuli, are determined by inherent individual factors, e.g., sex, and can be modulated by different conditioning mechanisms. This narrative review examines the factors that determine perception of digestive stimuli and the postprandial experience

Reversal of Conditioned Food Aversion Using a Cognitive Intervention : A Sham-Controlled, Randomized, Parallel Study

Background: Aversive conditioning weakens the gratifying value of a comfort meal. The aim was to determine the effect of a cognitive intervention to reverse aversive conditioning and restore hedonic postprandial response. Methods: This was a randomized, sham-controlled, single-blind, parallel study that was conducted on 12 healthy women (n = 6 in each group). The reward value of a comfort meal was measured on different days: at initial exposure, after aversive conditioning (administration of the same meal with a masked fat overload on the previous day) and after a cognitive intervention (disclosing the aversive conditioning paradigm in the test group vs. no explanation in the control group). The primary outcome, digestive wellbeing, was determined using graded scales at regular intervals before and after ingestion. Results: At initial exposure, the comfort meal produced a rewarding experience that was impaired using aversive conditioning; upon re-exposure to the original meal, the cognitive intervention increased meal wanting and liking; improved digestive wellbeing and mood; tended to reduce postprandial satiety, bloating/fullness; and abolished discomfort/pain, thereby restoring the hedonic value of the comfort meal. By contrast, sham intervention had no effects, and the postprandial sensations remained like the responses to the offending meal. Conclusion: In this proof-of-concept study, we demonstrate that in healthy women, a mild, short-term acquired aversion to a comfort meal can be reversed using a cognitive intervention

Ideen un mètode per evitar la regurgitació recurrent

La ruminació, la tornada del menjar cap a la boca després de ser ingerida, pot ser un problema menor o dur a complicacions nutricionals severes. L'equip del professor del Departament de Medicina de la UAB i investigador de l'Institut de Recerca Hospital Universitari Vall d'Hebron Fernando Azpiroz ha desenvolupat un mètode per ensenyar a qui la pateix a modular l'activitat muscular fins a suprimir aquest comportament.La rumiación, la vuelta de la comida hacia la boca después de ser ingerida, puede ser un problema menor o llevar a complicaciones nutricionales severas. El equipo del profesor del Departamento de Medicina de la UAB e investigador del Instituto de Investigación Hospital Universitario Vall d'Hebron Fernando Azpiroz ha desarrollado un método para enseñar a quienes la padecen a modular la actividad muscular hasta suprimir este comportamiento.Rumination, the regurgitation of recently ingested food into the mouth, can be a minor problem or lead to severe nutritional complications. Professor Fernando Azpiroz, from the UAB Department of Medicine and Vall d'Hebron Research Institute, and his team, have developed a new method to show people suffering from rumination how to modulate their muscular activity in order to suppress it

Effect of colonic distension on small bowel motility measured by jejunal high-resolution manometry

Colonic distension; High-resolution manometry; Small bowel motilityDistensió colònica; Manometria d'alta resolució; Motilitat de l'intestí primDistensión colónica; Manometría de alta resolución; Motilidad del intestino delgadoBackground Abnormal motility patterns in the jejunum can be detected in patients with prominent colonic content, and these abnormalities may be due to either a primary jejunal dysfunction or a reflex distortion. The objective of the present study was to determine the effect of colonic distension on small bowel postprandial motility using high-resolution manometry. Methods Single center, controlled, parallel, randomized, single blind study in healthy subjects testing the effect of colonic filling vs sham infusion on the responses to a meal in 16 healthy subjects. Nutrients were continuously infused in the proximal jejunum (2 Kcal/min) during the 2-h study period to induce a steady-state postprandial motor pattern. Jejunal motility was measured by water-perfused, high-resolution manometry. After 1 h postprandial recording (basal period), gas was infused during 7.5 min via a rectal tube (720 mL or sham infusion), and jejunal motility was recorded for another hour. Key Results Jejunal postprandial motility during the basal period was characterized by two overlapping components: a) continuous segmental activity (non-propagated or shortly propagated) and b) intercurrent propagated fronts (3.8 ± 1.1 fronts of 2-5 clustered contractions/h >10 cm propagation). As compared to sham infusion, colonic gas filling: a) inhibited continuous segmental contractile activity (by 17 ± 4%; p = 0.044 vs control group) and b) stimulated intermittent propagated fronts (up to 9.0 ± 2.2 fronts/h; p = 0.017 vs control group). Conclusions and Inferences Long retrograde reflexes induced by colonic distension distort the balance between segmental and propagated activity, and may affect the normal response of the jejunum to food ingestion. Jejunal manometry in patients may be artifacted by colonic overload

Visible abdominal distension in functional gut disorders: Objective evaluation

Abdominal distension; Abdominothoracic imaging; Intestinal gasDistensión abdominal; Imagen abdominotorácica; Gas intestinalDistensió abdominal; Imatge abdominotoràcica; Gas intestinalBackground Visible abdominal distension has been attributed to: (A) distorted perception, (B) intestinal gas accumulation, or (C) abdominophrenic dyssynergia (diaphragmatic push and anterior wall relaxation). Methods A pool of consecutive patients with functional gut disorders and visible abdominal distension included in previous studies (n = 139) was analyzed. Patients (61 functional bloating, 74 constipation-predominant irritable bowel syndrome and 4 with alternating bowel habit) were evaluated twice, under basal conditions and during a self-reported episode of visible abdominal distension; static abdominal CT images were taken in 104 patients, and dynamic EMG recordings of the abdominal walls in 76, with diaphragmatic activity valid for analysis in 35. Key Results (A) Objective evidence of abdominal distension was obtained by tape measure (increase in girth in 138 of 139 patients), by CT imaging (increased abdominal perimeter in 96 of 104 patients) and by abdominal EMG (reduced activity, i.e., relaxation, in 73 of 76 patients). (B) Intestinal gas volume was within ±300 ml from the basal value in 99 patients, and above in 5 patients, who nevertheless exhibited a diaphragmatic descent. (C) Diaphragmatic contraction was detected in 34 of 35 patients by EMG (increased activity) and in 82 of 103 patients by CT (diaphragmatic descent). Conclusions and Inferences In most patients complaining of episodes of visible abdominal distention: (A) the subjective claim is substantiated by objective evidence; (B) an increase in intestinal gas does not justify visible abdominal distention; (C) abdominophrenic dyssynergia is consistently evidenced by dynamic EMG recording, but static CT imaging has less sensitivity.The present study was supported in part by the Spanish Ministry of Science and Innovation (Dirección General de Investigación Científica y Técnica, PID2021-122295OB-I00); Ciberehd is funded by the Instituto de Salud Carlos III. Writing Assistance. American Journal Experts for English editing of the manuscript (Certificate Verification Code; 8696-2A19-A35A-3FAE-6987) funded by SAF 2016-76648-R

Digestive Symptoms in Healthy People and Subjects With Irritable Bowel Syndrome

Altres ajuts: Supported in full by Danone ResearchThe aim of this study was to validate the ability of symptom frequency questionnaire to differentiate between irritable bowel syndrome (IBS) patients and healthy subjects. A digestive symptom frequency questionnaire (DSFQ) was previously used in a food efficacy trial in a non-IBS population with mild gastrointestinal symptoms. We compared 2 well-defined populations: 100 IBS patients fulfilling Rome III criteria (mean age 32 y; range, 18 to 59 y), and 100 sex-matched and age-matched healthy subjects. Frequency of individual digestive symptoms (abdominal pain/discomfort, bloating, flatulence, borborygmi) was assessed using a 5-point Likert scale (from none to everyday of the week) and the IBS severity with the IBS-SSS questionnaire. Health-Related Quality of life (HRQoL) was assessed with the Food and Benefits Assessment (FBA) and Functional Digestive Disorders Quality of Life (FDDQL) questionnaires. The digestive (dis)comfort dimension of these questionnaires was considered as the main dimension for HRQoL. The DSFQ discriminated IBS from healthy subjects with a significant difference (P <0.001) between groups (estimated mean difference=5.58; 95% CI, 4.91-6.28). On the basis of the ROC curve (AUC=0.9479), a cutoff value of 5 gives a sensitivity of 92% and a specificity of 84%, with a positive likelihood ratio of 5.75. Composite score of symptoms correlated strongly (P <0.0001) with digestive discomfort measured by FDDQL (−0.816), digestive comfort measured by FBA (−0.789), and the IBS-SSS score (0.762). Measurement of digestive symptom frequency by means of the DSFQ can differentiate IBS from healthy subjects, and shows a good correlation with other validated questionnaires (clinical trial #NCT01457378

Quasi-automatic colon segmentation on T2-MRI images with low user effort

About 50% of the patients consulting a gastroenterology clinic report symptoms without detectable cause. Clinical researchers are interested in analyzing the volumetric evolution of colon segments under the effect of different diets and diseases. These studies require noninvasive abdominal MRI scans without using any contrast agent. In this work, we propose a colon segmentation framework designed to support T2-weighted abdominal MRI scans obtained from an unprepared colon. The segmentation process is based on an efficient and accurate quasiautomatic approach that drastically reduces the specialist interaction and effort with respect other state-of-the-art solutions, while decreasing the overall segmentation cost. The algorithm relies on a novel probabilistic tubularity filter, the detection of the colon medial line, probabilistic information extracted from a training set and a final unsupervised clustering. Experimental results presented show the benefits of our approach for clinical use.Peer ReviewedPostprint (author's final draft

Colonic content: effect of diet, meals, and defecation

This is the peer reviewed version of the following article: Bendezú, Á., Mego, M., Monclús, E., Merino, X., Accarino, A., Malagelada, J., Navazo, I., Azpiroz, F. Colonic content: effect of diet, meals, and defecation. "Neurogastroenterology and motility", Febrer 2017, vol. 29, núm. 2, which has been published in final form at [http://onlinelibrary.wiley.com.recursos.biblioteca.upc.edu/doi/10.1111/nmo.12930/full]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.The metabolic activity of colonic microbiota is influenced by diet; however, the relationship between metabolism and colonic content is not known. Our aim was to determine the effect of meals, defecation, and diet on colonic content. Methods: In 10 healthy subjects, two abdominal MRI scans were acquired during fasting, 1 week apart, and after 3 days on low- and high-residue diets, respectively. With each diet, daily fecal output and the number of daytime anal gas evacuations were measured. On the first study day, a second scan was acquired 4 hours after a test meal (n=6) or after 4 hours with nil ingestion (n=4). On the second study day, a scan was also acquired after a spontaneous bowel movement. Results: On the low-residue diet, daily fecal volume averaged 145 ± 15 mL; subjects passed 10.6 ± 1.6 daytime anal gas evacuations and, by the third day, non-gaseous colonic content was 479 ± 36 mL. The high-residue diet increased the three parameters to 16.5 ± 2.9 anal gas evacuations, 223 ± 19 mL fecal output, and 616 ± 55 mL non-gaseous colonic content (P<.05 vs low-residue diet for all). On the low-residue diet, non-gaseous content in the right colon had increased by 41 ± 11 mL, 4 hours after the test meal, whereas no significant change was observed after 4-hour fast (-15 ± 8 mL; P=.006 vs fed). Defecation significantly reduced the non-gaseous content in distal colonic segments. Conclusion & inferences: Colonic content exhibits physiologic variations with an approximate 1/3 daily turnover produced by meals and defecation, superimposed over diet-related day-to-day variations.Peer ReviewedPostprint (author's final draft

End to End Colonic Content Assessment: ColonMetry Application

Colon segmentation; Colonic content; Intestinal gasSegmentación de colon; Contenido colónico; Gas intestinalSegmentació del còlon; Contingut colònic; Gas intestinalThe analysis of colonic contents is a valuable tool for the gastroenterologist and has multiple applications in clinical routine. When considering magnetic resonance imaging (MRI) modalities, T2 weighted images are capable of segmenting the colonic lumen, whereas fecal and gas contents can only be distinguished in T1 weighted images. In this paper, we present an end-to-end quasi-automatic framework that comprises all the steps needed to accurately segment the colon in T2 and T1 images and to extract colonic content and morphology data to provide the quantification of colonic content and morphology data. As a consequence, physicians have gained new insights into the effects of diets and the mechanisms of abdominal distension.This work was supported by the Spanish Ministry of Science and Innovation (Proyectos de Generación de Conocimiento), PID2021-122295OB-I00, and Agencia Estatal de Investigación and Fondos FEDER, PID2021-122136OB-C21); Ciberehd is funded by the Instituto de Salud Carlos III