Functional Profiling Demonstrates That a Sulfide-Reducing Diet Achieves Microenvironmental Targets in Ulcerative Colitis.

Background: As a dietary approach to reducing inflammation in ulcerative colitis, the 4-SURE (4 Strategies to Sulfide Reduction) diet was designed to correct pathogenic alterations of excessive protein fermentation and hydrogen sulfide (H2S) production in the distal colon. We aimed to perform a deep functional analysis (microbial and metabolomic) of the feces of 28 adults with mild-moderately active ulcerative colitis who adhered to the 4-SURE diet over 8 weeks to explore whether the 4-SURE diet could modulate the intraluminal environment as intended.

Methods: Fecal samples were collected at week 0 and 8 of dietary intervention, processed and aliquoted.

Looking Beyond Nutrients, How to Assess Diet Quality in an Inflammatory Bowel Disease Population-A Narrative Review.

: Dietary assessment in inflammatory bowel disease (IBD) is moving away from individual food and nutrient analyses and towards dietary patterns (e.g., Mediterranean diet, Western diet) and diet quality assessment that are increasingly implicated in IBD onset and course.

Faecal microbiota transplant in Parkinson's disease: pilot study to establish safety & tolerability.

Emerging evidence suggests gut microbiota differences in Parkinson's Disease (PD) may impact disease progression and treatment. Faecal Microbiota Transplantation (FMT) offers a potential therapeutic approach. We conducted an open-label pilot study to assess the safety, tolerability, and symptom impact of FMT in 12 patients with mild to moderate PD, administered via enema for 6 months.

Frequent Dietetic Involvement Enhances Adherence and Clinical Outcomes of Exclusive Enteral Nutrition in Adults With Crohn's Disease.

Background And Aim: Use of Exclusive Enteral Nutrition (EEN) in adults has been limited by lack of defined protocols, poor adherence and perceived lack of efficacy. This study evaluated EEN therapy in adults with Crohn's disease (CD) to identify determinants of clinical efficacy, adherence, and therapy completion.

Methods: This retrospective, multicenter study included consecutive adults (≥ 18 years old) prescribed EEN for CD between February 1, 2019, and February 28, 2022, at two tertiary teaching hospitals.

Expert Position Statement: Defining the Role of Intestinal Ultrasound in Assessing Constipation and Faecal Loading.

Background: Intestinal ultrasound has been proposed as a tool to assess non-inflammatory functional gastrointestinal disorders, including constipation and faecal loading. However, well-defined sonographic criteria for these conditions are currently lacking.

Aim: To identify and establish specific sonographic parameters that could be used to assess constipation and faecal loading with intestinal ultrasound.

An International Consensus on Appropriate Management of Corticosteroids in Clinical Trials in Inflammatory Bowel Disease.

Background & Aims: Approval of new therapies for inflammatory bowel disease (IBD) requires rigorously designed and well-executed randomized controlled trials (RCTs). Corticosteroids remain a cornerstone of IBD induction therapy, and many patients in trials are enrolled while taking corticosteroids. Despite this, approaches to corticosteroid management in RCTs have been highly heterogeneous, often differing from clinical practice.

Translational strategies for oral delivery of faecal microbiota transplantation.

Faecal microbiota transplantation (FMT) has emerged as a transformative therapy for infections and shows promise for various GI and systemic diseases. However, the poor patient acceptability and accessibility of 'conventional' FMT, typically administered via colonoscopies or enemas, hinders its widespread clinical adoption, particularly for chronic conditions. Oral administration of FMT (OralFMT) overcomes these limitations, yet faces distinct challenges, including a significant capsule burden, palatability concerns and poor microbial viability during gastric transit.

Faecal microbiota transplantation in Crohn's disease: an Australian randomised placebo-controlled trial protocol.

Introduction: The enteric microbiota drives inflammation in Crohn's disease. Yet, there are no placebo controlled trials evaluating the efficacy and safety of faecal microbiota transplantation (FMT) in inducing and maintaining remission in patients with active Crohn's disease. The Microbial Restoration (MIRO) study aims to establish this evidence.

A study protocol for a double-blinded, randomised, placebo-controlled trial on the use of encapsulated FMT for reducing the side effects of HSCT: the HSCT-BIOME study.

Background: The composition of the gut microbiota both prior to and after haematopoietic stem cell transplantation (HSCT) is increasingly implicated in the outcomes of HSCT, including infections, poor immune reconstitution and disease relapse. Faecal microbiota transplantation (FMT) offers a potential strategy of supporting the gut microbiota and improve HSCT outcomes. Although FMT has been investigated in HSCT recipients, it has largely been evaluated therapeutically for indications such as infection, or once immunocompetency is regained.

Outcomes of Fecal Microbiota Transplantation for Infection in South Australia.

Background: Fecal microbiota transplantation (FMT) sourced from a bank of prescreened anaerobically processed frozen donor stool has been available in South Australia since 2013. This study aimed to evaluate the real-world clinical and safety outcomes of FMT for recurrent, refractory, and/or severe or fulminant infection (CDI) facilitated via this centralized facility.

Methods: Donor screening test data were prospectively collected on all donors who passed prescreening evaluations between April 2013 and August 2023.

Distinct Profiles of Fecal Volatile Organic Compounds Discriminate Ulcerative Colitis Patients With an Ileoanal Pouch From Those With an Intact Colon.

Fecal volatile organic compounds (VOCs) offer insights into gut microbiota function that may drive the pathogenesis of ulcerative colitis (UC). This cross-sectional study aimed to compare dietary intake and VOC patterns in UC patients with an ileoanal pouch compared to those with an intact colon. Seven-day food records and fecal samples were collected from UC patients with an intact colon (n = 28) or an ileoanal pouch (n = 11).

Meta-Analysis: Exclusive Enteral Nutrition in Adults With Ulcerative Colitis.

Background: Exclusive enteral nutrition (EEN) is an established dietary therapy for Crohn's disease but its role in ulcerative colitis remains unclear.

Aims: To investigate the efficacy of EEN in adults with active ulcerative colitis and compare variations in treatment protocols, safety, tolerability and adherence.

Methods: We conducted a systematic search of MEDLINE, Embase, Cochrane CENTRAL, Emcare, CINAHL, Web of Science and trial registries for articles published from inception until July 21, 2024.

Hypercoagulation After Hospital Discharge in Acute Severe Ulcerative Colitis: A Prospective Study.

Background & Aims: Venous thromboembolism is a serious complication during and following hospitalization with acute severe ulcerative colitis (ASUC). We evaluated serial thrombotic profiles of patients with ASUC from the point of hospitalization up to 12 weeks postdischarge and compared these with control patients with quiescent ulcerative colitis.

Methods: Twenty-seven patients with ASUC and 25 control patients with quiescent ulcerative colitis were recruited.

Patients with functional gastrointestinal disorders spend less time in tertiary care when managed by a single clinician: results of a multicentre audit in South Australia.

Background And Aims: Functional gastrointestinal disorders (FGIDs) impact quality of life and represent a significant burden on healthcare services. Guidelines recommend an early, positive diagnosis to reduce harmful over-investigation in FGID patients. The aim of this multicentre study was to evaluate FGID management against current guidelines.

International expert guidance for defining and monitoring small bowel strictures in Crohn's disease on intestinal ultrasound: a consensus statement.

Background: Diagnostic imaging using CT enterography, magnetic resonance enterography, and intestinal ultrasound are important tools in evaluating stricturing Crohn's disease. Definitions of strictures have been developed for CT enterography and magnetic resonance enterography. However, expert recommendations for definitions and treatment response of strictures on intestinal ultrasound are not available.

Depression influences fatigue in inflammatory bowel disease amongst other factors: a structural modelling approach.

Objectives: Fatigue is common in people with inflammatory bowel disease (IBD) and is associated with IBD activity, sleep disturbance, anxiety and depression. The relative contribution of these factors to fatigue is unclear. This study aimed to investigate the relationship between fatigue and these factors through a novel approach using structural equation modelling.

Reliability of Intestinal Ultrasound for Evaluating Crohn's Disease Activity Using Point-of-care and Central Reading.

Background & Aims: Intestinal ultrasound (IUS) is increasingly used to assess Crohn's disease (CD) activity in clinical practice. However, application in clinical trials has been limited by heterogeneous scoring methods and concerns about reliability. We aimed to determine the inter- and intra-rater reliability of locally and centrally read IUS parameters for evaluating CD using prospectively performed scans.

Sleep quality is associated with reduced quality of life in inflammatory bowel disease through its interaction with pain.

Background And Aim: Quality of life is reduced in people with inflammatory bowel disease (IBD) and poor sleep is prevalent in people with IBD. This study aimed to investigate the influence of sleep on quality of life (QoL) in people with inflammatory bowel disease.

Methods: An online questionnaire was administered through three tertiary IBD centers, social media, and through Crohn's Colitis Australia.

Food-Based Interventions as Therapy for Inflammatory Bowel Disease: Important Steps in Diet Trial Design and Reporting of Outcomes.

Diet therapy for inflammatory bowel disease (IBD) is an international research priority but guidance for IBD-specific diet trial design is lacking. This review critically evaluates key elements of prospective IBD food-based intervention trials and identifies gaps. Electronic databases were searched for interventional IBD diet studies.

Switching from Dose-Intensified intravenous to SubCutaneoUS infliximab in Inflammatory Bowel Disease (DISCUS-IBD): protocol for a multicentre randomised controlled trial.

Introduction: A substantial proportion of patients with inflammatory bowel disease (IBD) on intravenous infliximab require dose intensification. Accessing additional intravenous infliximab is labour-intensive and expensive, depending on insurance and pharmaceutical reimbursement. Observational data suggest that subcutaneous infliximab may offer a convenient and safe alternative to maintain disease remission in patients requiring dose-intensified infliximab.

Revolution in diet therapy for inflammatory bowel disease.

Until recently, diet as a therapeutic tool to treat inflammatory bowel disease (IBD) has not been proven effective. Nearly a century in the making we are in the grips of a revolution in diet therapies for IBD, driven by emerging data revealing diet as a key environmental factor associated with IBD susceptibility, and observational studies suggesting that dietary intake may play a role in the disease course of established IBD. This review summarizes the current evidence for diets trialed as induction and maintenance therapy for IBD.

Genomic analysis of Helicobacter pylori in Australia: Antimicrobial resistance, phylogenetic patterns, and virulence factors.

Background And Aim: Rates of antimicrobial-resistant Helicobacter pylori infection are rising globally, but little is known about contemporary resistance patterns, virulence factors, and phylogenetic patterns of isolates within Australia. We aimed to characterize antimicrobial resistance and genetic mutations associated with adverse clinical outcomes.

Methods: Whole genome sequencing, culturing, and antibiotic sensitivity data for refractory H.