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Does “Irritable Bowel Syndrome” exist?

November 03, 2021

¿Existe el “Síndrome del Intestino Irritable”?

How many people today report abdominal bloating or constipation? I am sure that if we ask several family members and/or friends, we will find more than two or three people who report having poor digestion.

Having a little bloating when we eat large meals or our belly swells a little after eating lightly are not worrying symptoms, but rather it is a natural process of the digestive process itself: we should not be alarmed.

However, multiple factors can cause our digestive system to not function as it should and we feel heartburn, reflux, bad breath, gas, diarrhea or cramps on a daily basis. These are symptoms that a healthy person should not have every day and yet, many normalize them.

What factors influence poor digestion?

If we have basic levels of stress and anxiety, it is very likely that our digestive system will be altered. For example, the normal activation of gastric juices such as hydrochloric acid in the stomach can be affected by the constant activation of the “fight or flight” mechanism, causing a higher pH and a lower production of digestive enzymes and factors necessary for correct absorption of ingested nutrients.

The feeding plays a very important role: consuming foods rich in trans fats such as industrial pastries, abuse of simple carbohydrates such as sugary drinks or alcohol, affects the bacteria that colonize our intestine and colon, also irritating the entire digestive tract, increasing the chances from suffering intestinal diseases of an inflammatory nature.

Let's put ourselves in context

We go to the doctor because we have swelling, they perform a colonoscopy, a basic blood test and a culture, all negative, “you are perfect,” they say. Finally we were diagnosed with “Irritable Bowel Syndrome (IBS). and “functional dyspepsia”, that we learn to manage stress better, perhaps they recommend a FODMAPS diet.

What is meant by Irritable Bowel Syndrome?

Irritable bowel syndrome (IBS), also known as irritable bowel syndrome, is a functional digestive disorder characterized by abdominal pain and changes in bowel habits.

At the moment, the pathophysiological mechanism is not known exact trigger of IBS, although it is related to psychosocial factors that produce alterations in intestinal motility, release of inflammatory mediators, interactions of the brain-gut axis, psychosocial factors and alterations of the intestinal microbiota that are related to small intestinal bacterial overgrowth (SIBO) and colon dysbiosis .

The most frequent symptoms are:

  • Frequency of bowel movements less or more than three times a week.
  • Excessive straining, defecatory urgency and sensation of incomplete evacuation.
  • Feeling of abdominal swelling.
  • Stools with intestinal mucus.

But... I eat very healthy and I'm learning to manage my stress... And yet I still feel bad and bloated!

Unfortunately, there is NO single treatment and diet for the treatment of inflammatory digestive diseases; General recommendations can be given such as better managing stress, having a better lifestyle and avoiding cereal abuse, but IBS is a set of symptoms for which we must find the cause.

Most people who suffer from IBS have a unbalanced microbiota . We know that there are various genes involved in this type of pathology (defects in the detection of antigens, defects in the phagocytosis of pathogens or aberrant responses of the immune system), but in reality the vast majority of cases are due to intestinal dysbiosis.

Intestinal dysbiosis is observed in these patients, sometimes associated with genetic factors and lower taxonomic diversity, with an increase in the Firmicutes phylum, a reduction in the Bacteroidetes phylum and the Lactobacillus and Bifidobacterium genera. In addition, there is also an increase in intestinal populations of Streptococcus and Ruminococcus .

In the specific case of IBS patients with symptoms of constipation (instead of diarrhea), a lower level of populations of the phylum Actinobacteria (such as the genus Bifidobacterium ) and higher populations of the phylum Bacteroidetes (genus Veillonella ) are observed. family Enterobacteriaceae , from Staphylococcus aureus and methane-producing archaea.

Such is the importance of the microbiota that one of the strategies in patients with IBS and IBD (Chron's Disease or Ulcerative Colitis) is fecal microbiota transplantation (FMT) from healthy subjects. The clinical trials carried out to date show that this intervention reduces symptoms and inflammatory outbreaks in most cases and, therefore, could be adopted as a routine treatment for this pathology, which would support the fact that dysbiosis indeed intestinal is one of the main factors for this disease.

That is, the change from the dysbiotic (unbalanced) microbiota to a balanced one improves the symptoms of the person diagnosed with IBS in most cases.

What is the problem?

The problem we encounter most is poor diagnosis due to ignorance of how the Human Microbiota works and the tests that we have available today on the market , which, although they still need greater precision, are much more complete than a culture. We need patients to perform more specific tests beyond classic cultures and colonoscopies to be able to detect if the patient has a lack of bacterial diversity, or proliferation of pathogenic microorganisms (bacteria, parasites, fungi or viruses) or if their diet is not adequate. adequate, which are usually the most common causes.

Tests such as massive sequencing analysis, microbiota analysis by 16S (PCR), organic metabolites test, visceral sensitivity to certain foods (especially certain cereals), analysis of genetic polymorphisms related to lactose intolerance, celiac disease, fructose and histamine or air tests are essential to be able to analyze the patient's situation before diagnosing them with a chronic pathology.

You are not a label or a disease, you suffer from a series of symptoms that must be well analyzed by an up-to-date health professional.

If you want to find the cause of your digestive discomfort and get rid of the "irritable bowel" label, request your appointment here .

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