2.1. Participants
anxiety, liver and renal diseases, allergy, Crohn’s disease, depression, Depression, Psychosomatic complaints, Anxiety, abdominal pain, diabetes, bloating, diarrhea, IBS-D, bowel movements, SIBO, lowered mood, loose stools ranged from 3, colitis, duodenal, small intestinal, watery
CELIAC DISEASE, BACTERIAL DISEASES, ALLERGY, DIABETES, SMALL INTESTINAL BACTERIAL OVERGROWTH, FOOD INTOLERANCE, DISEASES, COLITIS
120 subjects, recruited in 2017–2021, participated in this study. The control group included 40 healthy subjects without any complaints (marked as Group I, controls). The 80 patients were divided into two groups based on nutritional intervention (low-FODMAP or low-TRP and FODMAP diet). The Gastrointestinal Symptom Rating Scale (GSRS-IBS), the Hamilton Anxiety Rating Scale (HAM-A), and the Hamilton Depression Rating Scale (HAM-D) were used to analyze abdominal symptoms and the mental state of subjects as described previously [Rome IV criteria for selecting patients were as follows: loose or watery stools occurred at least 25% of the time for six months. All patients experienced abdominal pain associated with bowel movements (the number of loose stools ranged from 3 to 8 per day); in addition, they complained of bloating. The physiological condition had a direct effect on the psychological state of the patients, in whom anxiety, lowered mood, and sleep disturbances were observed. Psychosomatic complaints persisted or recurred despite symptomatic treatment from 14 months to 6 years. Further factors for inclusion in the study group include the intensity of abdominal pain and diarrhea above 4 points on the GSRS, the score being above 24, and the results of HAM-A and HAM-D being above 11 points. Other than IBS-D diseases of the GI tract, all patients were excluded with endoscopic and histological examination of gastric, duodenal, small intestinal, and colonic mucosa. We also ruled out small intestinal bacterial overgrowth (SIBO) with the results of the lactulose hydrogen breath test (Gastrolyzer, Bedfont, Ltd., Harrietsham, UK). We excluded from the current study all patients who had a diagnosis of colitis, celiac disease, Crohn’s disease, allergy or food intolerance, parasitic and bacterial diseases, liver and renal diseases, diabetes, severe anxiety, or depression. Exclusion criteria also included the use of any drugs that could interfere with the aims of this study (including antibiotics, probiotics, and psychotropics) in the month prior to enrolment in the study.Prior to undertaking the study, ethical clearance was obtained from all subjects. The study was conducted according to the guidelines of the Declaration of Helsinki and the Guidelines for Good Clinical Practice and approved by the Bioethics Committee of the Medical University of Lodz (RNN/176/18/KE).