[19, 27] These methodologies are being formally validated for app

[19, 27] These methodologies are being formally validated for application to enteral formulas. The appropriateness of using HPLC and enzymatic assays to accurately represent the FODMAP content of enteral formulas is currently under investigation. Once confirmed for application in enteral formulas, the analysis of specific formula ingredients for FODMAP content may assist

in better understanding of potential problems associated with enteral formula use. However, the effect of these formulas in inducing GI symptoms including diarrhea needs to be further investigated. A randomized, controlled trial comparing inpatients receiving Isosource 1.5 to inpatients receiving a formula of similar nutrient composition of a higher FODMAP content would confirm or disprove the initial findings

of the reduced risk of EN-associated diarrhea. Implications Selleckchem HIF inhibitor of the higher FODMAP content of enteral formula contributing to EN-associated Buparlisib purchase diarrhea are development of enteral formulas of lower FODMAP content and conducting prospective studies investigating the efficacy of changing formulas once diarrhea has developed. “
“See article in J. Gastroenterol. Hepatol. 2010; 25: 453–468 Inflammatory bowel diseases (IBD) were rare in Asia until two decades ago. For those Asian countries in which epidemiological, case series or hospital resource use data exist, there has been a consistent rise in the incidence and prevalence

rates for both Crohn’s disease (CD) and ulcerative colitis (UC).1,2 This relatively rapid increase, such as the six-fold increase of UC in Hong Kong over a relatively short period of time, is considered to be the result of environmental changes.3 The increase in inflammatory bowel diseases parallels these countries’ economic growth and increasing affluence, which has mostly occurred after the 1970′s. The increasing incidence of IBD has been recognized for both CD and UC, indicating that this rise did not result Thalidomide simply from a reclassification from one to the other. Overall, UC still predominates over CD in most parts of Asia.1 The difficulty in the study of IBD in Asia arises from the lack of population-based registries in most countries, some patients’ preference to present to traditional and alternative health practitioners or therapists, the limited availability of diagnostic facilities or difficulties in accessing them, and low awareness of IBD among doctors due to their previous rarity. Despite these difficulties, single centre studies and collective multi-centre studies, and in the case of Japan, population-based studies, have shown rising rates of IBD all around the same time. Genotyping studies in Asia are of interest as they differ distinctly from Caucasians. The NOD2 gene polymorphisms found to be associated with the development of CD in Caucasians are not apparent in Asians.

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