Trygve Hausken | Haukeland University Hospital, Bergen, Norway (original) (raw)

Papers by Trygve Hausken

Research paper thumbnail of Abnormal small intestinal endocrine cells in IBS El-Salhy 2010

Research paper thumbnail of Irritable Bowel Syndrome: What Is It?

Understanding and Controlling the Irritable Bowel, 2015

Irritable bowel syndrome (IBS) is a common gastrointestinal disorder that affects between 5 and 2... more Irritable bowel syndrome (IBS) is a common gastrointestinal disorder that affects between 5 and 20 % of the Western world.

Research paper thumbnail of Diet and Irritable Bowel Syndrome, with a Focus on Appetite-Regulating Gut Hormones

Nutrition in the Prevention and Treatment of Abdominal Obesity, 2014

Irritable bowel syndrome (IBS) is a common gastrointestinal disorder with a prevalence of 5–20% a... more Irritable bowel syndrome (IBS) is a common gastrointestinal disorder with a prevalence of 5–20% and an incidence of 200/100,000. It is not known to be associated with the development of serious disease or with increased mortality, but it does considerably reduce the quality of life for patients and is an economic burden to society. Diet plays an important role in triggering the symptoms of IBS, especially the intake of foods that are rich in fermentable oligo-, di-, and monosaccharides, and polyols (FODMAPs), by influencing the dominance of Clostridium spp. in the intestinal flora and inducing abnormalities in gut endocrine cells. Dietary guidance aimed at establishing healthy eating habits by avoiding foods rich in FODMAPs and insoluble fiber and adjusting food composition has been found to reduce symptoms and improve the quality of life in IBS patients. Endocrine cells that produce several anorexigenic hormones in the gut are depleted in IBS patients, but the impact of this on appetite and body mass index in IBS patients is not known. Further studies are urgently needed to clarify this issue.

Research paper thumbnail of Understanding and Controlling the Irritable Bowel

part of the material is concerned, specifi cally the rights of translation, reprinting, reuse of ... more part of the material is concerned, specifi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfi lms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use.

Research paper thumbnail of High densities of serotonin and peptide YY cells in the colon of patients with lymphocytic colitis

World Journal of Gastroenterology, 2012

Author contributions: El-Salhy M contributed to the study design, performed research, analysed th... more Author contributions: El-Salhy M contributed to the study design, performed research, analysed the results and wrote the paper; Gundersen D, Hatlebakk JG and Hausken T contributed equally to the study design and analysis of the results.

Research paper thumbnail of Abnormal Small-Intestinal Endocrine Cells in Patients with Irritable Bowel Syndrome

Digestive Diseases and Sciences, 2010

Background General disturbances in gastrointestinal motility have been reported in patients with ... more Background General disturbances in gastrointestinal motility have been reported in patients with irritable bowel syndrome (IBS). The gastrointestinal tract hormones play an important role in regulating gastrointestinal motility. Aims To investigate a possible abnormality in the small intestinal endocrine cells of IBS patients. Methods Included in the study were 41 patients with irritable bowel syndrome according to Rome Criteria III and 42 healthy controls. Duodenal biopsies were obtained from both patients and controls during gastroscopy. The biopsies were immunostained by avidin-biotin-complex method for secretin, CCK, GIP, somatostatin, and serotonin cells. The cell densities were quantified by computerized image analysis. Results The density of secretin-and CCK-immunoreactive cells in patients with IBS was significantly reduced. The reduction in secretin and CCK cells occurred only in IBS-diarrhea patients, but not in IBS-constipation subtype. Both GIP and somatostatin cell densities were reduced in the duodenum of IBS patients. There was no statistical difference between the subtypes of IBS patients, regarding secretin, CCK, GIP, or somatostatin cell densities. Serotonin cell density was not affected in patients with IBS. Conclusions The low densities of secretin and CCK cells in IBS-diarrhea patients may cause a functional pancreatic insufficiency as well as inadequate gall emptying, as these hormones stimulate pancreatic bicarbonate and enzyme secretion and CCK stimulates as well gall bladder contraction. Low densities of secretin, GIP, and somatostatin cells in IBS patients might result in a high secretion of gastric acid, as secretin, GIP, and somatostatin inhibit gastric acid secretion. Keywords Computer image analysis Á Endocrine cells Á IBS Á Small intestine Á Immunohistochemistry

Research paper thumbnail of Low Densities of Serotonin and Peptide YY Cells in the Colon of Patients with Irritable Bowel Syndrome

Digestive Diseases and Sciences, 2011

Background The gut hormones are important in regulating gastrointestinal motility. Disturbances i... more Background The gut hormones are important in regulating gastrointestinal motility. Disturbances in gastrointestinal motility have been reported in patients with irritable bowel syndrome (IBS). Reduced endocrine cell density, as revealed by chromogranin A, has been reported in the colon of IBS patients. Aims To investigate a possible abnormality in the colonic endocrine cells of IBS patients. Methods A total of 41 patients with IBS according to Rome Criteria III and 20 controls were included in the study. Biopsies from the right and left colon were obtained from both patients and controls during colonoscopy. The biopsies were immunostained for serotonin, peptide YY (PYY), pancreatic polypeptide (PP), entroglucagon, and somatostatin cells. Cell densities were quantified by computerized image analysis. Results Serotonin and PYY cell densities were reduced in the colon of IBS patients. PP, entroglucagon, and somatostatin-immunoreactive cells were too few to enable reliable quantification. Conclusion The cause of these observations could be primary genetic defect(s), secondary to altered serotonin and/or PYY signaling systems and/or subclinical inflammation. Serotonin activates the submucosal sensory branch of the enteric nervous system and controls gastrointestinal motility and chloride secretion via interneurons and motor neurons. PYY stimulates absorption of water and electrolytes, and inhibits prostaglandin (PG) E2, and vasoactive intestinal peptide, which stimulates intestinal fluid secretion and is a major regulator of the ''ileal brake''. Although the cause and effect relationship of these findings is difficult to elucidate, the abnormalities reported here might contribute to the symptoms associated with IBS.

Research paper thumbnail of Development of functional gastrointestinal disorders after Giardia lambliainfection

BMC Gastroenterology, 2009

Background: Functional gastrointestinal disorders (FGID) may occur following acute gastroenteriti... more Background: Functional gastrointestinal disorders (FGID) may occur following acute gastroenteritis. This long-term complication has previously not been described after infection with the non-invasive protozoan Giardia lamblia. This study aims to characterize persistent abdominal symptoms elicited by Giardia infection according to Rome II criteria and symptoms scores. Methods: Structured interview and questionnaires 12-30 months after the onset of Giardia infection, and at least 6 months after Giardia eradication, among 82 patients with persisting abdominal symptoms elicited by the Giardia infection. All had been evaluated to exclude other causes. Results: We found that 66 (80.5%) of the 82 patients had symptoms consistent with irritable bowel syndrome (IBS) and 17 (24.3%) patients had functional dyspepsia (FD) according to Rome II criteria. IBS was sub classified into D-IBS (47.0%), A-IBS (45.5%) and C-IBS (7.6%). Bloating, diarrhoea and abdominal pain were reported to be most severe. Symptoms exacerbation related to specific foods were reported by 45 (57.7%) patients and to physical or mental stress by 34 (44.7%) patients. Conclusion: In the presence of an IBS-subtype pattern consistent with post-infectious IBS (PI-IBS), and in the absence of any other plausible causes, we conclude that acute Giardia infection may elicit functional gastrointestinal diseases with food and stress related symptoms similar to FGID patients in general.

Research paper thumbnail of Low vagal tone and antral dysmotility in patients with functional dyspepsia

Psychosomatic Medicine, 1993

Effects of acute mental stress on gastric antral motility were investigated in 23 healthy persons... more Effects of acute mental stress on gastric antral motility were investigated in 23 healthy persons and 25 patients with functional dyspepsia (FD). Real-time ultrasonography of gastric antrum was recorded, after ingestion of 500 ml meat soup, during a 4-min resting period, 2.5 min of mental stress, and a 4-min recovery period. Amplitude of antral contractions was scored as a fraction of relaxed area. Motility-index was calculated as the amplitude multiplied by frequency. Measurement of skin conductance reflected sympathetic tone, and respiratory sinus arrhythmia (RSA) was calculated to index vagal tone. Antral motility was reduced by mental stress in the healthy persons, but not in FD patients. Group differences were significant for amplitude (p < 0.002) and motility-index scores (p < 0.02). Sympathetic tone increased during stress in both groups. Vagal tone was lower in the FD patients than in the healthy controls (p < 0.001). The lack of stress-related reduction of motility among patients with FD may, therefore, be a consequence of poor vagal tone.

Research paper thumbnail of The Effect of Supplementation with Low Doses of a Cod Protein Hydrolysate on Satiety Hormones and Inflammatory Biomarkers in Adults with Metabolic Syndrome: A Randomized, Double-Blind Study

Nutrients, 2020

Metabolic syndrome (MetS) is characterised by metabolic abnormalities that increase the risk of d... more Metabolic syndrome (MetS) is characterised by metabolic abnormalities that increase the risk of developing type 2 diabetes mellitus and cardiovascular disease. Altered levels of circulating ghrelin, several adipokines and inflammatory markers secreted from adipose tissue, such as leptin, adiponectin, tumor necrosis factor alpha, are observed in overweight and obese individuals. We assessed the effect of supplementation with low doses of a cod protein hydrolysate (CPH) on fasting and postprandial levels of acylated ghrelin, as well as fasting levels of adiponectin, leptin and inflammatory markers in subjects with MetS. A multicentre, double-blinded, randomized controlled trial with a parallel group design was conducted. Subjects received a daily supplement of CPH (4 g protein, n = 15) or placebo (0 g protein, n = 15). We observed no effect on fasting or postprandial levels of acylated ghrelin, fasting levels of adiponectin (p = 0.089) or leptin (p = 0.967) after supplementation with ...

Research paper thumbnail of Supplementation with Low Doses of a Cod Protein Hydrolysate on Glucose Regulation and Lipid Metabolism in Adults with Metabolic Syndrome: A Randomized, Double-Blind Study

Nutrients, 2020

The risk of cardiovascular diseases and type 2 diabetes mellitus are increased in subjects with m... more The risk of cardiovascular diseases and type 2 diabetes mellitus are increased in subjects with metabolic syndrome (MetS), and hydrolyzed fish protein may have favorable effects on metabolic health. Here, we investigated the effect of 8 weeks supplementation with 4 g of cod protein hydrolysate (CPH) on glucose metabolism, lipid profile and body composition in individuals with MetS in a double-blind, randomized intervention study with a parallel-group design. Subjects received a daily supplement of CPH (n = 15) or placebo (n = 15). Primary outcomes were serum fasting and postprandial glucose levels. Secondary outcomes were fasting and postprandial insulin and glucagon-like peptide 1 (GLP-1), fasting lipid concentrations and body composition. No difference was observed between CPH and placebo for insulin, glucose or GLP-1 after 8 weeks intervention. Fasting triacylglycerol decreased in both the CPH group and placebo group, with no change between groups. Fasting total cholesterol and l...

Research paper thumbnail of Possible role of peptide YY (PYY) in the pathophysiology of irritable bowel syndrome (IBS)

Neuropeptides, 2019

Irritable bowel syndrome (IBS) is a common gastrointestinal disorder of unknown aetiology for whi... more Irritable bowel syndrome (IBS) is a common gastrointestinal disorder of unknown aetiology for which there is no effective treatment. Although IBS does not increase mortality, it reduces the quality of life and is an economic burden to both the patients themselves and society as a whole. Peptide YY (PYY) is localized in endocrine cells located in the ileum, colon and rectum. The concentration of PYY and the density of PYY cells are decreased in both the colon and rectum but unchanged in the ileum of patients with IBS. The low density of PYY cells in the large intestine may be caused by a decreased number of stem cells and their progeny toward endocrine cells. PYY regulates the intestinal motility, secretion and absorption as well as visceral sensitivity via modulating serotonin release. An abnormality in PYY may therefore contribute to the intestinal dysmotility and visceral hypersensitivity seen in IBS patients. Diet management involving consuming a low-FODMAP diet restores the density of PYY cells in the large intestine and improves abdominal symptoms in patients with IBS. This review shows that diet management appears to be a valuable tool for correcting the PYY abnormalities in the large intestine of IBS patients in the clinic.

Research paper thumbnail of Increasing the Dose and/or Repeating Faecal Microbiota Transplantation (FMT) Increases the Response in Patients with Irritable Bowel Syndrome (IBS)

Nutrients, 2019

Background: Faecal microbiome transplantation (FMT) appears to be an effective method for treatin... more Background: Faecal microbiome transplantation (FMT) appears to be an effective method for treating irritable bowel syndrome (IBS) patients. However, it is not clear if a high transplant dose and/or repeating FMT are/is needed to ensure a response. The present study was undertaken to clarify this matter. Methods: Ten IBS patients who did not respond to a 30-g transplant subsequently received a 60-g transplant into the duodenum via a gastroscope. The patients provided faecal samples before and 1 month after FMT. They completed five questionnaires measuring symptoms, fatigue and quality of life at baseline and then at 2 weeks, 1 month and 3 months after FMT. The dysbiosis index (DI) was measured using the GA-map Dysbiosis Test®. Results: Seven patients (70%) responded to the 60-g transplant, with significant clinical improvements in the abdominal symptoms, fatigue and quality of life in 57%, 80% and 67% of these patients. The 60-g transplant also reduced the DI. Conclusion: FMT is an e...

Research paper thumbnail of Peroral endoscopic pyloromyotomy for primary pyloric stenosis

Research paper thumbnail of Reduction in duodenal endocrine cells in irritable bowel syndrome is associated with stem cell abnormalities

World Journal of Gastroenterology, 2015

Author contributions: El-Salhy M planned the study, recruited the patients, performed gastroscopi... more Author contributions: El-Salhy M planned the study, recruited the patients, performed gastroscopies, analyzed the data and drafted the manuscript; Hatlebakk JG and Hausken T checked the study plan, read the manuscript and contributed to interpretation and analysis of the results; all authors approved the version of the article to be published.

Research paper thumbnail of The relation between celiac disease, nonceliac gluten sensitivity and irritable bowel syndrome

Nutrition Journal, 2015

Wheat products make a substantial contribution to the dietary intake of many people worldwide. De... more Wheat products make a substantial contribution to the dietary intake of many people worldwide. Despite the many beneficial aspects of consuming wheat products, it is also responsible for several diseases such as celiac disease (CD), wheat allergy, and nonceliac gluten sensitivity (NCGS). CD and irritable bowel syndrome (IBS) patients have similar gastrointestinal symptoms, which can result in CD patients being misdiagnosed as having IBS. Therefore, CD should be excluded in IBS patients. A considerable proportion of CD patients suffer from IBS symptoms despite adherence to a gluten-free diet (GFD). The inflammation caused by gluten intake may not completely subside in some CD patients. It is not clear that gluten triggers the symptoms in NCGS, but there is compelling evidence that carbohydrates (fructans and galactans) in wheat does. It is likely that NCGS patients are a group of self-diagnosed IBS patients who self-treat by adhering to a GFD.

Research paper thumbnail of Irritable bowel syndrome the role of gut neuroendocrine peptides

Frontiers in Bioscience, 2012

Introduction 3. The neuroendocrine peptides of the gut 4. The possible role of the gut neuroendoc... more Introduction 3. The neuroendocrine peptides of the gut 4. The possible role of the gut neuroendocrine peptides/amines in the pathogenesis of IBS 5. The gut neuroendocrine peptides/amines as a tool in the diagnosis of IBS 6. The gut neuroendocrine peptides/amines use in the treatment of IBS 7. Conclusion 8. Acknowledgements 9. References

Research paper thumbnail of Irritable bowel syndrome: treatment options

Research paper thumbnail of Low-grade inflammation in the rectum of patients with sporadic irritable bowel syndrome

Molecular medicine reports, 2013

Irritable bowel syndrome (IBS) is a common chronic gastrointestinal disorder that considerably re... more Irritable bowel syndrome (IBS) is a common chronic gastrointestinal disorder that considerably reduces quality of life and is an economic burden on society. The pathogenesis of IBS is unknown. However, intestinal low‑grade inflammation has been proposed as one of the factors contributing to the development of IBS. The present study aimed to examine the possible occurrence of low‑grade inflammation in the rectum of patients with sporadic IBS. In total, 50 patients (42 females and 8 males with an average age of 34 years) with sporadic IBS fulfilling the Rome III Criteria were recruited for this study. Of these, 30 patients had IBS with diarrhoea as the predominant symptom (IBS‑D) and 20 patients had IBS with constipation as the predominant symptom (IBS‑C). A total of 27 control subjects (19 females and 8 males with an average age of 53 years) were included. The patients and controls underwent colonoscopy with rectal biopsies. The biopsies were immunostained for total leucocytes, lymph...

Research paper thumbnail of Evaluation of the usefulness of colonoscopy with mucosal biopsies in the follow-up of TNBS-induced colitis in rats

Molecular medicine reports, 2013

Animal models are required for research regarding the pathogenesis and efficacy of anti-inflammat... more Animal models are required for research regarding the pathogenesis and efficacy of anti-inflammatory agents in inflammatory bowel disease (IBD). Trinitrobenzene sulfonic acid (TNBS)-induced colitis closely mimics Crohn's disease. The present study was undertaken in order to determine the reliability of following the inflammatory course of TNBS-induced colitis using colonoscopy together with biopsy samples obtained during the examination. In this study we used 20 adult male Wistar rats, with a mean weight of 201.9 g. The rats were divided into two groups, control and TNBS, with ten rats in each group. Following the induction of TNBS colitis, the rats underwent colonoscopy with mucosal biopsies. At the end of the experiment, the rats were sacrificed and whole-wall colonic samples were obtained. The degree of inflammation was assessed endoscopically, macroscopically and microscopically. There was no significant change in the body weight of the control group but significant weight l...

Research paper thumbnail of Abnormal small intestinal endocrine cells in IBS El-Salhy 2010

Research paper thumbnail of Irritable Bowel Syndrome: What Is It?

Understanding and Controlling the Irritable Bowel, 2015

Irritable bowel syndrome (IBS) is a common gastrointestinal disorder that affects between 5 and 2... more Irritable bowel syndrome (IBS) is a common gastrointestinal disorder that affects between 5 and 20 % of the Western world.

Research paper thumbnail of Diet and Irritable Bowel Syndrome, with a Focus on Appetite-Regulating Gut Hormones

Nutrition in the Prevention and Treatment of Abdominal Obesity, 2014

Irritable bowel syndrome (IBS) is a common gastrointestinal disorder with a prevalence of 5–20% a... more Irritable bowel syndrome (IBS) is a common gastrointestinal disorder with a prevalence of 5–20% and an incidence of 200/100,000. It is not known to be associated with the development of serious disease or with increased mortality, but it does considerably reduce the quality of life for patients and is an economic burden to society. Diet plays an important role in triggering the symptoms of IBS, especially the intake of foods that are rich in fermentable oligo-, di-, and monosaccharides, and polyols (FODMAPs), by influencing the dominance of Clostridium spp. in the intestinal flora and inducing abnormalities in gut endocrine cells. Dietary guidance aimed at establishing healthy eating habits by avoiding foods rich in FODMAPs and insoluble fiber and adjusting food composition has been found to reduce symptoms and improve the quality of life in IBS patients. Endocrine cells that produce several anorexigenic hormones in the gut are depleted in IBS patients, but the impact of this on appetite and body mass index in IBS patients is not known. Further studies are urgently needed to clarify this issue.

Research paper thumbnail of Understanding and Controlling the Irritable Bowel

part of the material is concerned, specifi cally the rights of translation, reprinting, reuse of ... more part of the material is concerned, specifi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfi lms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use.

Research paper thumbnail of High densities of serotonin and peptide YY cells in the colon of patients with lymphocytic colitis

World Journal of Gastroenterology, 2012

Author contributions: El-Salhy M contributed to the study design, performed research, analysed th... more Author contributions: El-Salhy M contributed to the study design, performed research, analysed the results and wrote the paper; Gundersen D, Hatlebakk JG and Hausken T contributed equally to the study design and analysis of the results.

Research paper thumbnail of Abnormal Small-Intestinal Endocrine Cells in Patients with Irritable Bowel Syndrome

Digestive Diseases and Sciences, 2010

Background General disturbances in gastrointestinal motility have been reported in patients with ... more Background General disturbances in gastrointestinal motility have been reported in patients with irritable bowel syndrome (IBS). The gastrointestinal tract hormones play an important role in regulating gastrointestinal motility. Aims To investigate a possible abnormality in the small intestinal endocrine cells of IBS patients. Methods Included in the study were 41 patients with irritable bowel syndrome according to Rome Criteria III and 42 healthy controls. Duodenal biopsies were obtained from both patients and controls during gastroscopy. The biopsies were immunostained by avidin-biotin-complex method for secretin, CCK, GIP, somatostatin, and serotonin cells. The cell densities were quantified by computerized image analysis. Results The density of secretin-and CCK-immunoreactive cells in patients with IBS was significantly reduced. The reduction in secretin and CCK cells occurred only in IBS-diarrhea patients, but not in IBS-constipation subtype. Both GIP and somatostatin cell densities were reduced in the duodenum of IBS patients. There was no statistical difference between the subtypes of IBS patients, regarding secretin, CCK, GIP, or somatostatin cell densities. Serotonin cell density was not affected in patients with IBS. Conclusions The low densities of secretin and CCK cells in IBS-diarrhea patients may cause a functional pancreatic insufficiency as well as inadequate gall emptying, as these hormones stimulate pancreatic bicarbonate and enzyme secretion and CCK stimulates as well gall bladder contraction. Low densities of secretin, GIP, and somatostatin cells in IBS patients might result in a high secretion of gastric acid, as secretin, GIP, and somatostatin inhibit gastric acid secretion. Keywords Computer image analysis Á Endocrine cells Á IBS Á Small intestine Á Immunohistochemistry

Research paper thumbnail of Low Densities of Serotonin and Peptide YY Cells in the Colon of Patients with Irritable Bowel Syndrome

Digestive Diseases and Sciences, 2011

Background The gut hormones are important in regulating gastrointestinal motility. Disturbances i... more Background The gut hormones are important in regulating gastrointestinal motility. Disturbances in gastrointestinal motility have been reported in patients with irritable bowel syndrome (IBS). Reduced endocrine cell density, as revealed by chromogranin A, has been reported in the colon of IBS patients. Aims To investigate a possible abnormality in the colonic endocrine cells of IBS patients. Methods A total of 41 patients with IBS according to Rome Criteria III and 20 controls were included in the study. Biopsies from the right and left colon were obtained from both patients and controls during colonoscopy. The biopsies were immunostained for serotonin, peptide YY (PYY), pancreatic polypeptide (PP), entroglucagon, and somatostatin cells. Cell densities were quantified by computerized image analysis. Results Serotonin and PYY cell densities were reduced in the colon of IBS patients. PP, entroglucagon, and somatostatin-immunoreactive cells were too few to enable reliable quantification. Conclusion The cause of these observations could be primary genetic defect(s), secondary to altered serotonin and/or PYY signaling systems and/or subclinical inflammation. Serotonin activates the submucosal sensory branch of the enteric nervous system and controls gastrointestinal motility and chloride secretion via interneurons and motor neurons. PYY stimulates absorption of water and electrolytes, and inhibits prostaglandin (PG) E2, and vasoactive intestinal peptide, which stimulates intestinal fluid secretion and is a major regulator of the ''ileal brake''. Although the cause and effect relationship of these findings is difficult to elucidate, the abnormalities reported here might contribute to the symptoms associated with IBS.

Research paper thumbnail of Development of functional gastrointestinal disorders after Giardia lambliainfection

BMC Gastroenterology, 2009

Background: Functional gastrointestinal disorders (FGID) may occur following acute gastroenteriti... more Background: Functional gastrointestinal disorders (FGID) may occur following acute gastroenteritis. This long-term complication has previously not been described after infection with the non-invasive protozoan Giardia lamblia. This study aims to characterize persistent abdominal symptoms elicited by Giardia infection according to Rome II criteria and symptoms scores. Methods: Structured interview and questionnaires 12-30 months after the onset of Giardia infection, and at least 6 months after Giardia eradication, among 82 patients with persisting abdominal symptoms elicited by the Giardia infection. All had been evaluated to exclude other causes. Results: We found that 66 (80.5%) of the 82 patients had symptoms consistent with irritable bowel syndrome (IBS) and 17 (24.3%) patients had functional dyspepsia (FD) according to Rome II criteria. IBS was sub classified into D-IBS (47.0%), A-IBS (45.5%) and C-IBS (7.6%). Bloating, diarrhoea and abdominal pain were reported to be most severe. Symptoms exacerbation related to specific foods were reported by 45 (57.7%) patients and to physical or mental stress by 34 (44.7%) patients. Conclusion: In the presence of an IBS-subtype pattern consistent with post-infectious IBS (PI-IBS), and in the absence of any other plausible causes, we conclude that acute Giardia infection may elicit functional gastrointestinal diseases with food and stress related symptoms similar to FGID patients in general.

Research paper thumbnail of Low vagal tone and antral dysmotility in patients with functional dyspepsia

Psychosomatic Medicine, 1993

Effects of acute mental stress on gastric antral motility were investigated in 23 healthy persons... more Effects of acute mental stress on gastric antral motility were investigated in 23 healthy persons and 25 patients with functional dyspepsia (FD). Real-time ultrasonography of gastric antrum was recorded, after ingestion of 500 ml meat soup, during a 4-min resting period, 2.5 min of mental stress, and a 4-min recovery period. Amplitude of antral contractions was scored as a fraction of relaxed area. Motility-index was calculated as the amplitude multiplied by frequency. Measurement of skin conductance reflected sympathetic tone, and respiratory sinus arrhythmia (RSA) was calculated to index vagal tone. Antral motility was reduced by mental stress in the healthy persons, but not in FD patients. Group differences were significant for amplitude (p < 0.002) and motility-index scores (p < 0.02). Sympathetic tone increased during stress in both groups. Vagal tone was lower in the FD patients than in the healthy controls (p < 0.001). The lack of stress-related reduction of motility among patients with FD may, therefore, be a consequence of poor vagal tone.

Research paper thumbnail of The Effect of Supplementation with Low Doses of a Cod Protein Hydrolysate on Satiety Hormones and Inflammatory Biomarkers in Adults with Metabolic Syndrome: A Randomized, Double-Blind Study

Nutrients, 2020

Metabolic syndrome (MetS) is characterised by metabolic abnormalities that increase the risk of d... more Metabolic syndrome (MetS) is characterised by metabolic abnormalities that increase the risk of developing type 2 diabetes mellitus and cardiovascular disease. Altered levels of circulating ghrelin, several adipokines and inflammatory markers secreted from adipose tissue, such as leptin, adiponectin, tumor necrosis factor alpha, are observed in overweight and obese individuals. We assessed the effect of supplementation with low doses of a cod protein hydrolysate (CPH) on fasting and postprandial levels of acylated ghrelin, as well as fasting levels of adiponectin, leptin and inflammatory markers in subjects with MetS. A multicentre, double-blinded, randomized controlled trial with a parallel group design was conducted. Subjects received a daily supplement of CPH (4 g protein, n = 15) or placebo (0 g protein, n = 15). We observed no effect on fasting or postprandial levels of acylated ghrelin, fasting levels of adiponectin (p = 0.089) or leptin (p = 0.967) after supplementation with ...

Research paper thumbnail of Supplementation with Low Doses of a Cod Protein Hydrolysate on Glucose Regulation and Lipid Metabolism in Adults with Metabolic Syndrome: A Randomized, Double-Blind Study

Nutrients, 2020

The risk of cardiovascular diseases and type 2 diabetes mellitus are increased in subjects with m... more The risk of cardiovascular diseases and type 2 diabetes mellitus are increased in subjects with metabolic syndrome (MetS), and hydrolyzed fish protein may have favorable effects on metabolic health. Here, we investigated the effect of 8 weeks supplementation with 4 g of cod protein hydrolysate (CPH) on glucose metabolism, lipid profile and body composition in individuals with MetS in a double-blind, randomized intervention study with a parallel-group design. Subjects received a daily supplement of CPH (n = 15) or placebo (n = 15). Primary outcomes were serum fasting and postprandial glucose levels. Secondary outcomes were fasting and postprandial insulin and glucagon-like peptide 1 (GLP-1), fasting lipid concentrations and body composition. No difference was observed between CPH and placebo for insulin, glucose or GLP-1 after 8 weeks intervention. Fasting triacylglycerol decreased in both the CPH group and placebo group, with no change between groups. Fasting total cholesterol and l...

Research paper thumbnail of Possible role of peptide YY (PYY) in the pathophysiology of irritable bowel syndrome (IBS)

Neuropeptides, 2019

Irritable bowel syndrome (IBS) is a common gastrointestinal disorder of unknown aetiology for whi... more Irritable bowel syndrome (IBS) is a common gastrointestinal disorder of unknown aetiology for which there is no effective treatment. Although IBS does not increase mortality, it reduces the quality of life and is an economic burden to both the patients themselves and society as a whole. Peptide YY (PYY) is localized in endocrine cells located in the ileum, colon and rectum. The concentration of PYY and the density of PYY cells are decreased in both the colon and rectum but unchanged in the ileum of patients with IBS. The low density of PYY cells in the large intestine may be caused by a decreased number of stem cells and their progeny toward endocrine cells. PYY regulates the intestinal motility, secretion and absorption as well as visceral sensitivity via modulating serotonin release. An abnormality in PYY may therefore contribute to the intestinal dysmotility and visceral hypersensitivity seen in IBS patients. Diet management involving consuming a low-FODMAP diet restores the density of PYY cells in the large intestine and improves abdominal symptoms in patients with IBS. This review shows that diet management appears to be a valuable tool for correcting the PYY abnormalities in the large intestine of IBS patients in the clinic.

Research paper thumbnail of Increasing the Dose and/or Repeating Faecal Microbiota Transplantation (FMT) Increases the Response in Patients with Irritable Bowel Syndrome (IBS)

Nutrients, 2019

Background: Faecal microbiome transplantation (FMT) appears to be an effective method for treatin... more Background: Faecal microbiome transplantation (FMT) appears to be an effective method for treating irritable bowel syndrome (IBS) patients. However, it is not clear if a high transplant dose and/or repeating FMT are/is needed to ensure a response. The present study was undertaken to clarify this matter. Methods: Ten IBS patients who did not respond to a 30-g transplant subsequently received a 60-g transplant into the duodenum via a gastroscope. The patients provided faecal samples before and 1 month after FMT. They completed five questionnaires measuring symptoms, fatigue and quality of life at baseline and then at 2 weeks, 1 month and 3 months after FMT. The dysbiosis index (DI) was measured using the GA-map Dysbiosis Test®. Results: Seven patients (70%) responded to the 60-g transplant, with significant clinical improvements in the abdominal symptoms, fatigue and quality of life in 57%, 80% and 67% of these patients. The 60-g transplant also reduced the DI. Conclusion: FMT is an e...

Research paper thumbnail of Peroral endoscopic pyloromyotomy for primary pyloric stenosis

Research paper thumbnail of Reduction in duodenal endocrine cells in irritable bowel syndrome is associated with stem cell abnormalities

World Journal of Gastroenterology, 2015

Author contributions: El-Salhy M planned the study, recruited the patients, performed gastroscopi... more Author contributions: El-Salhy M planned the study, recruited the patients, performed gastroscopies, analyzed the data and drafted the manuscript; Hatlebakk JG and Hausken T checked the study plan, read the manuscript and contributed to interpretation and analysis of the results; all authors approved the version of the article to be published.

Research paper thumbnail of The relation between celiac disease, nonceliac gluten sensitivity and irritable bowel syndrome

Nutrition Journal, 2015

Wheat products make a substantial contribution to the dietary intake of many people worldwide. De... more Wheat products make a substantial contribution to the dietary intake of many people worldwide. Despite the many beneficial aspects of consuming wheat products, it is also responsible for several diseases such as celiac disease (CD), wheat allergy, and nonceliac gluten sensitivity (NCGS). CD and irritable bowel syndrome (IBS) patients have similar gastrointestinal symptoms, which can result in CD patients being misdiagnosed as having IBS. Therefore, CD should be excluded in IBS patients. A considerable proportion of CD patients suffer from IBS symptoms despite adherence to a gluten-free diet (GFD). The inflammation caused by gluten intake may not completely subside in some CD patients. It is not clear that gluten triggers the symptoms in NCGS, but there is compelling evidence that carbohydrates (fructans and galactans) in wheat does. It is likely that NCGS patients are a group of self-diagnosed IBS patients who self-treat by adhering to a GFD.

Research paper thumbnail of Irritable bowel syndrome the role of gut neuroendocrine peptides

Frontiers in Bioscience, 2012

Introduction 3. The neuroendocrine peptides of the gut 4. The possible role of the gut neuroendoc... more Introduction 3. The neuroendocrine peptides of the gut 4. The possible role of the gut neuroendocrine peptides/amines in the pathogenesis of IBS 5. The gut neuroendocrine peptides/amines as a tool in the diagnosis of IBS 6. The gut neuroendocrine peptides/amines use in the treatment of IBS 7. Conclusion 8. Acknowledgements 9. References

Research paper thumbnail of Irritable bowel syndrome: treatment options

Research paper thumbnail of Low-grade inflammation in the rectum of patients with sporadic irritable bowel syndrome

Molecular medicine reports, 2013

Irritable bowel syndrome (IBS) is a common chronic gastrointestinal disorder that considerably re... more Irritable bowel syndrome (IBS) is a common chronic gastrointestinal disorder that considerably reduces quality of life and is an economic burden on society. The pathogenesis of IBS is unknown. However, intestinal low‑grade inflammation has been proposed as one of the factors contributing to the development of IBS. The present study aimed to examine the possible occurrence of low‑grade inflammation in the rectum of patients with sporadic IBS. In total, 50 patients (42 females and 8 males with an average age of 34 years) with sporadic IBS fulfilling the Rome III Criteria were recruited for this study. Of these, 30 patients had IBS with diarrhoea as the predominant symptom (IBS‑D) and 20 patients had IBS with constipation as the predominant symptom (IBS‑C). A total of 27 control subjects (19 females and 8 males with an average age of 53 years) were included. The patients and controls underwent colonoscopy with rectal biopsies. The biopsies were immunostained for total leucocytes, lymph...

Research paper thumbnail of Evaluation of the usefulness of colonoscopy with mucosal biopsies in the follow-up of TNBS-induced colitis in rats

Molecular medicine reports, 2013

Animal models are required for research regarding the pathogenesis and efficacy of anti-inflammat... more Animal models are required for research regarding the pathogenesis and efficacy of anti-inflammatory agents in inflammatory bowel disease (IBD). Trinitrobenzene sulfonic acid (TNBS)-induced colitis closely mimics Crohn's disease. The present study was undertaken in order to determine the reliability of following the inflammatory course of TNBS-induced colitis using colonoscopy together with biopsy samples obtained during the examination. In this study we used 20 adult male Wistar rats, with a mean weight of 201.9 g. The rats were divided into two groups, control and TNBS, with ten rats in each group. Following the induction of TNBS colitis, the rats underwent colonoscopy with mucosal biopsies. At the end of the experiment, the rats were sacrificed and whole-wall colonic samples were obtained. The degree of inflammation was assessed endoscopically, macroscopically and microscopically. There was no significant change in the body weight of the control group but significant weight l...