Nerve stimulation may be potential therapy for leaky gut diseases

Stimulating the vagal nerve may improve
gut permeability: study

by Anne Crawford

Research by Monash Central Clinical School scientists has suggested that stimulating the vagal nerve transcutaneously improves gut permeability and could potentially counter diseases caused by intestinal barrier dysfunction or ‘leaky gut’.  

Intestinal barrier dysfunction is likely to initiate diseases such as Irritable Bowel Syndrome (IBS), Inflammatory Bowel Disease (IBD) and Crohn’s disease.

Partnership working to make ‘food as medicine’ simple, effective and enjoyable

Monash University is teaming up with a US company, ModifyHealth, to improve user experience of the App.

Monash University has partnered with a United States-based company, ModifyHealth, to raise further awareness in the US of the FODMAP diet protocol and the Monash University FODMAP Diet App, which have helped millions of people manage irritable bowel syndrome (IBS). The partnership will increase engagement with US consumers and healthcare providers, and expand awareness of the latest research and developments of the FODMAP diet protocol.

CCS researchers' high citation rates recognised by Web of Science

Congratulations to Central Clinical School colleagues Professor Peter Gibson (Department of Gastroenterology) and Professor Kathryn Holt (Department of Infectious Diseases), who have been named on the 2020 Web of Science Highly Cited (HiCi)'s list: https://recognition.webofscience.com/awards/highly-cited/2020/. This recognises leading researchers in their fields over the last decade, demonstrated by the production of multiple highly-cited papers that rank in the top 1% by citations for field and year in the Web of Science™ .

See other Monash researchers on the 2020 HiCi list here.

Coeliac disease: on the rise or just being reported more?

Professor Peter Gibson asks the question of whether the reported
rise of coeliac disease is due to the rise in incidence or detection.

by Anne Crawford

It’s a question pondered in both medical science and the community: does the rising rate of a chronic disease – in this case, coeliac disease – mean that it is being detected more or is the rate of the disease really rising? Or both?

The distinction is critical to clinical and scientific responses to such changes, Head of the Department of Gastroenterology Professor Peter Gibson argues in a recent opinion piece in Alimentary Pharmacology and Therapeutics. The journal was commemorating landmark studies published over the last decade or two, including that of seminal research on coeliac disease rates by Lohi et al in 2007.

Translational study on high-fibre diet an eye-opener for PhD science student

Paul Gill, PhD student, has published his

first paper investigating the influence of a

high-fibre diet on SCFAs in the blood.

Follow Paul on Twitter @gillpaul93

by Anne Crawford

When PhD candidate Paul Gill began his biomedical science course at Monash University he had no idea his studies would immerse him in one of the most dynamic fields of contemporary science: the gut microbiome.

Paul’s first paper, recently published in The European Journal of Nutrition, highlighted the potential of dietary fibre therapy to manipulate the production of short chain fatty acids (SCFA) and blood plasma concentrations. SCFAs are a group of organic acids produced in the gut from the bacterial fermentation of fibre in fruit, vegetables and certain grains. They are important for gut health but then absorbed into the bloodstream.

Gluten isn't bad for healthy people

Dr Emma Halmos (L) & Prof Peter Gibson

Unless you have been medically diagnosed with coeliac disease or gluten sensitivity, a rigorous new study shows that eating foods containing gluten will cause you no harm, and avoiding these proteins in your diet isn't necessary.

Professor Peter Gibson and Dr Emma Halmos, Monash Department of Gastroenterology, write an editorial accompanying this new study publication in the journal Gastroenterology. See the full story at  Science Alert.

Translational Research Symposium Speaker Spotlight - Prof Peter Gibson

Prof Peter Gibson

Monash University's 3rd annual Translational Research Symposium is being hosted by its three metropolitan clinical schools on 31 July 2017. The symposium will host a diverse group of medical researchers presenting their work into translational research. RSVP here.

Professor Peter Gibson is the Head of the Department of Gastroenterology. He also led the team, along with Dr Jane Muir, who developed the very popular low FODMAP Diet app.

Media mentions: IBS and hypnotherapy on ABC 7.30 report

Prof Peter Gibson, head of the Department of Gastroenterology, CCS and Dr Simone Peters, PhD graduate from the department, talk about hypnotherapy and its value for Irritable Bowel Syndrome. Dr Peters said that it worked equally well as the low FODMAP dietary intervention. See full clip of the 27 April 2017 7.30 Report - ABC feature: www.abc.net.au/7.30/content/2017/s4660149.htm

Low FODMAP diet may help women with endometriosis, IBS

Judy Moore is a PhD student with the Monash

University Department of Gastroenterology

by Anne Crawford

Endometriosis is a chronic gynaecological condition affecting up to 10% of women. It is characterised by symptoms such as pelvic pain and severe dysmenorrhoea (period pain) but also by symptoms typically associated with Irritable Bowel Syndrome (IBS).

A Central Clinical School PhD student investigating the link between the two conditions has found that a low FODMAP diet appears effective in women with concurrent endometriosis and IBS.

Congratulations to Gastroenterology for NHMRC '10 of the best' 2015

The National Health and Medical Research Council has announced its pick for 2015 research in its "Ten of the Best".
Congratulations to Peter Gibson and his team for their research on the actual effect of gluten in IBS being chosen as one of the ten. The document quotes Prof Gibson as saying:
“We demonstrated that gluten, without FODMAPs, did not specifically induce symptoms in patients who believed they were gluten intolerant.
“Indeed, all patients experienced reduced gut symptoms in the run-in period when they, for the first time, restricted all FODMAPs in their diet.
“We found no changes in the physiology of the gut in response to gluten.”
Link: 
https://www.nhmrc.gov.au/_files_nhmrc/file/publications/nhmrc_-10-of-the-best-2015_0.pdf

Congratulations to the Gastroenterology FODMAP team for Dean's Award!

The low FODMAP research team at the 2013 Central Clinical School public lecture given by Peter Gibson.
L-R: Mr Alex Bogatyrev (Research scientist), Dr Jaci Barrett (Senior lecturer), Ms Amanda Banfield (Research Dietician), Ms Caroline Tuck (PhD student), Ms Simone Peters (PhD student), Prof Peter Gibson (HOD), Debbie King (Research chef), Ms Georgia Somers-Jones (Administrative Officer), Ms Emma Halmos (PhD student), Ms Phillipa Settle (Administrative Officer), Dr Jane Muir (Head, Translational Nutrition group), Ms CK Yao (PhD student), Ms Bernadette Kirwan (Administrative Officer).

Congratulations to Professor Peter Gibson, Dr Jane Muir & the FODMAP team, who are the recipients of the Dean's Awards in Excellence in Research Impact (Economic and Social Impact) team award in 2016. The date of the official presentation is 1 August 2016.

They have developed the Monash Low FODMAP diet app which is the highest selling medical app in Australia and now downloaded in over 100 countries worldwide. Their public lecture and animation videos have been seen by over 130,000 people.

See more about Low FODMAP diet research and products at Monash:

• Website: http://www.med.monash.edu/cecs/gastro/fodmap/
• App: http://www.med.monash.edu/cecs/gastro/fodmap/iphone-app.html
• Booklet: http://ecommerce.med.monash.edu.au/product.asp?pID=317&cID=11&c=17231
• Animation video link:  https://youtu.be/Z_1Hzl9o5ic
• 2013 public lecture video link: https://www.youtube.com/watch?v=ByszVbFBPtY

Recent CCS publications: Week ending 6 May 2016

Prof Harshal Nandurkar with Dr Sarah
Kamel. See more about their research

Recent publications for CCS affiliated authors:

Ho P, Lim HY, Chua CC, Sleeman M, Tacey M, Donnan G, Nandurkar H. Retrospective review on isolated distal deep vein thrombosis (IDDVT) - A benign entity or not? Thromb Res. 2016 Apr; 142:11-16.
doi: 10.1016/j.thromres.2016.04.003.

Tremblay CS, Brown FC, Collett M, Saw J, Chiu SK, Sonderegger SE, Lucas SE, Alserihi R, Chau N, Toribio ML, McCormack MP, Chircop M, Robinson PJ, Jane SM, Curtis DJ. Loss-of-function mutations of Dynamin 2 promote T-ALL by enhancing IL-7 signalling. Leukemia. 2016 Apr 27. 
doi: 10.1038/leu.2016.100. [Epub ahead of print]

Wright EK, Kamm MA, De Cruz P, Hamilton AL, Ritchie KJ, Krejany EO, Gorelik A, Liew D, Prideaux L, Lawrance IC, Andrews JM, Bampton PA, Sparrow MP, Florin TH, Gibson PR, Debinski H, Gearry RB, Macrae FA, Leong RW, Kronborg I, Radford-Smith G, Selby W, Johnston MJ, Woods R, Elliott PR, Bell SJ, Brown SJ, Connell WR, Desmond PV. Effect of intestinal resection on quality of life in Crohn's disease. J Crohns Colitis. 2015 Jun; 9:452-62.
doi: 10.1093/ecco-jcc/jjv058

Zou H, Tabrizi SN, Grulich AE, Hocking JS, Garland SM, Bradshaw CS, Cornall AM, Fairley CK, Chen MY. Antibody responses following incident anal and penile infection with human papillomavirus in teenage men who have sex with men. Int J Cancer. 2016 Mar (online).
doi: 10.1002/ijc.30093.

Recent CCS publications: Week ending 8 April 2016

Professor Christopher Fairley (centre) with colleagues. Prof
Fairley is Director of the Melbourne Sexual Health Centre

Recent publications with Central Clinical School affiliated authors:

Bilardi JE, Walker S, Mooney-Somers J, Temple-Smith M, McNair R, Bellhouse C, Fairley CK, Chen MY, Bradshaw C. Women’s views and experiences of the triggers for onset of bacterial vaginosis and exacerbating factors associated with recurrence.  PLoS ONE. 2016 Mar; 11:e0150272.
doi:10.1371/journal.pone.0150272.

A gluten-free diet improves symptoms of coeliac disease

By Dr Jodie Abramovitch

Coeliac disease is a condition in which the immune system launches an inflammatory response to gluten. In healthy individuals, this immune reaction does not occur. Due to the inflammatory response, patients with coeliac disease typically have damaged small intestines which can lead to malnutrition, weight loss and gastrointestinal symptoms such as nausea and bloating.

A gluten-free diet is ‘prescribed’ for patients with coeliac disease. Currently, prospective studies of the short and long term effects of a gluten-free diet on the symptoms and pathology of coeliac disease are lacking.

Professor Peter Gibson - Head of the Department
of Gastroenterology

Monash researchers from the Eastern Health Clinical School and supervised by Professor Peter Gibson from the Department of Gastroenterology at the Central Clinical School aimed to determine the time frame in which intestinal damage and associated nutritional deficiencies caused by coeliac disease were successfully treated.

Development of intestinal gas capsules

By Dr Jodie Abramovitch

Many types of gases are produced within our digestive systems. Alterations in the type and amount of these gases can alter gut function, and potentially be a sign of disease.

Professor Peter Gibson - Head of the
Department of Gastroenterology

In a cross-disciplinary collaborative project including Monash researchers from the Department of Gastroenterology, a new intestinal gas capsule has been developed. These capsules has been designed to be swallowed so as to allow access to the gut in a non-invasive manner. Here they can sample the gases present and transmit their concentration and location (based on time lapsed following ingestion of the capsule) within the gut.

To test the capsules, pigs on high or low fibre diets were given the capsules. Pigs on a high fibre diet had higher concentrations of carbon dioxide (CO₂) and lower hydrogen gas (H₂) within their gastrointestinal tract than pigs given a low fibre diet. These findings were consistent with previous studies which measured gases in the guts of pigs on low and high fibre diets using classical (more invasive) techniques. As such, this study has shown that intestinal gas capsules can effectively provide information on the "where and what" regarding gas production in the gut, information that can only be determined presently by invasive techniques that are not possible to perform on humans.

Though the capsules require further refinement before they can be considered for use in humans, this study has shown that they have great potential to effectively and non-invasively detect gases within the gut. This will allow for a better understanding of the physiology of the gut  and permit easier detection and assessment of gut disorders within the clinic and inform treatment options.

Reference: Kalantar-Zadeh K, Yao CK, Berean KJ, Ha N, Ou JZ, Ward SA, Pillai N, Hill J, Cottrell JJ, Dunshea FR, McSweeney C, Muir JG, Gibson PR. Intestinal gas capsules: a proof-of-concept demonstration. Gastroenterology. 2016 Jan: 150;37-9
doi: 10.1053/j.gastro.2015.07.072

Picture essay of the week: FODMAP testing

The Department of Gastroenterology has a world wide following for its low FODMAP diet as therapy for Irritable Bowel Syndrome sufferers. They have created a picture essay of how they go about testing their foods for #FODMAPs, which are various types of sugars, present in a huge variety of foods but to varying degrees.

On a FODMAP related issue, ABC Catalyst are broadcasting a show, "Gluten: A gut feeling", on Tuesday, 24 Nov 2015, featuring Professor Peter Gibson, Head of  Department, who has done widely cited research on so-called non coeliac gluten sensitivity (NCGS). See reference for original article.

The low FODMAP diet and its application in East and Southeast Asia

Thai green curry. Image: Monash Dept of Gastroenterology

There is growing interest in using food choice/dietary change to influence clinical outcomes in patients with irritable bowel syndrome (IBS). The low fermentable oligo-, di-, mono-saccharides, and polyols (FODMAPs) diet is an evidence-based approach that is increasingly used in many Western countries, and holds great promise in treating IBS patients in East and Southeast Asia. However, the success of this dietary approach greatly depends on detailed knowledge about the FODMAP composition of food commonly consumed in that country.

Monitoring Crohn's disease after surgery

Prof Peter Gibson, one of the
study's authors

Crohn's disease (CD) usually recurs after intestinal resection; postoperative endoscopic monitoring and tailored treatment can reduce the chance of recurrence. The researchers investigated whether monitoring levels of fecal calprotectin (FC) can substitute for endoscopic analysis of the mucosa. In this analysis of data from a prospective clinical trial, FC measurement has sufficient sensitivity and NPV values to monitor for CD recurrence after intestinal resection. Its predictive value might be used to identify patients most likely to relapse. After treatment for recurrence, the FC level can be used to monitor response to treatment. It predicts which patients will have disease recurrence with greater accuracy than CRP level or CDAI score.

Gluten doesn't deserve its villainous reputation: Professor Peter Gibson on Radio NZ National

Photo: AFP / Sofie Delauw / Cultura Creative

Professor Peter Gibson, Head, Department of Gastroenterology, explains why gluten is not "the villain of the food world" and why he believes most of those following a gluten free diet may be doing themselves more harm than good.
26/02/2015 Radio New Zealand National: "Is gluten the devil in your food?"

Study looks at small intestinal bacterial overgrowth in patients with Parkinson's disease

Source: shakeitup.org

CCS researchers conducted a study this year which looked at small intestinal bacterial overgrowth in Parkinson's disease, and a possible association with gastrointestinal symptoms and worse motor function.