title: Dietary guidance normalizes large intestinal endocrine cell densities in patients with irritable bowel syndrome.
abstract: OBJECTIVE
  To determine the large intestinal endocrine cell types affected following dietary guidance in patients with irritable bowel syndrome (IBS).
  
  
  METHODS
  The study included 13 IBS patients and 13 control subjects. The patients received three sessions of individualized dietary guidance. Both the control subjects and the patients were scheduled for colonoscopies at baseline and again for the patients at 3-9 months after dietary guidance. Biopsy samples were taken from the colon and rectum and were immunostained for all types of large intestinal endocrine cells. The endocrine cells were quantified using computerized image analysis.
  
  
  RESULTS
  The daily total consumption (mean±s.e.m. values) of fruits and vegetables rich in FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) decreased significantly from 16.2±5.3 g before receiving dietary guidance to 9.2±3.2 g after receiving dietary guidance (P=0.02). In the total colon, the densities of serotonin cells were 46.8±8.9, 10.5±2.1 and 22.6±3.2 cells/mm(2) in control subjects and in IBS patients before and after receiving dietary guidance, respectively (P=0.007); the corresponding densities of peptide YY cells were 11.6±1.8, 10.8±1.7 and 16.8±2.1 cells/mm(2), respectively (P=0.06). The cell densities for both serotonin and peptide YY did not change significantly in the rectum. The densities of somatostatin cells in the rectum were 13.5±3.0, 13.2±3.0, and 22.3±3.2 cells/mm(2) for control subjects and for IBS patients before and after receiving dietary guidance, respectively (P=0.01).
  
  
  CONCLUSIONS
  The densities of the large intestinal endocrine cells tend to normalize following dietary guidance that may have contributed to the improvement of the patients with IBS symptoms.
authors.affiliation: Division of Gastroenterology, Department of Medicine, Stord Hospital, Stord, Norway.|Division of Gastroenterology, Department of Clinical Medicine, University of Bergen, Bergen, Norway.|National Centre for Functional Gastrointestinal Disorders, Department of Medicine, Haukeland University Hospital, Bergen, Norway.
authors.forename: T
authors.identifier: http://orcid.org/0000-0001-7983-3707
authors.initials: T
authors.lastname: Mazzawi
authors.affiliation: Division of Gastroenterology, Department of Clinical Medicine, University of Bergen, Bergen, Norway.|National Centre for Functional Gastrointestinal Disorders, Department of Medicine, Haukeland University Hospital, Bergen, Norway.
authors.forename: T
authors.initials: T
authors.lastname: Hausken
authors.affiliation: Department of Research, Helse-Fonna, Haugesund, Norway.
authors.forename: D
authors.initials: D
authors.lastname: Gundersen
authors.affiliation: Division of Gastroenterology, Department of Medicine, Stord Hospital, Stord, Norway.|Division of Gastroenterology, Department of Clinical Medicine, University of Bergen, Bergen, Norway.|National Centre for Functional Gastrointestinal Disorders, Department of Medicine, Haukeland University Hospital, Bergen, Norway.
authors.forename: M
authors.initials: M
authors.lastname: El-Salhy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002452:Cell Count; D003106:Colon / Q000473:pathology; D004435:Eating; D019858:Enteroendocrine Cells / Q000166:cytology*; D005260:Female; D005638:Fruit; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000178:diet therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D019894:Peptide YY; D012007:Rectum / Q000473:pathology; D012701:Serotonin; D013004:Somatostatin; D014675:Vegetables; D055815:Young Adult
chemical_list: D019894:Peptide YY; D012701:Serotonin; D013004:Somatostatin