What is irritable bowel syndrome?
Irritable bowel syndrome (IBS) is a functional disorder of the digestive system that causes abdominal pain, bloating, gas, and changes in bowel habits, such as diarrhea and constipation. IBS is a chronic condition, meaning it can last for a long time and may require long-term treatment. In this article, we will discuss the causes, symptoms, and treatments of IBS, as well as frequently asked questions about this topic.
Irritable bowel syndrome: what are we talking about?
Irritable bowel syndrome (IBS) is an intestinal disorder classified as a functional disorder. It is a chronic, persistent disorder of the gastrointestinal system. Today, it affects many people and its prevalence is particularly high.
IBS takes the form of functional manifestations (the famous disorders): changes in intestinal motility, increased or decreased transit speed (diarrhea, constipation) with or without alternation of the two, intestinal cramps accompanied by pain.
Irritable bowel syndrome does not have “universal” manifestations.
The clinical manifestations of irritable bowel syndrome (IBS) vary from person to person. Some experience diarrhea, others constipation, or an alternation of both. To clarify the situation, IBS has been classified into subtypes based on stool consistency, as assessed using the Bristol Stool Scale . Thus, there are subgroups with predominantly constipation and others with predominantly diarrhea. These criteria are included in the Rome criteria, which are validated by expert consensus and epidemiological data to assess the status of the disease.
Definition of irritable bowel syndrome according to the Rome criteria
The 4th revision of the Rome criteria defined irritable bowel syndrome (IBS). “Irritable bowel syndrome is a disorder of the gut-brain interaction.” IBS is defined as abdominal pain occurring at least one day per week for three months with at least two of the following criteria:
- change in stool consistency
- change in bowel movement frequency
- relief from pain during defecation
People who are prone to IBS have one or more of the following conditions:
- intestinal motility disorders
- an increase in intestinal sensitivity (visceral hypersensitivity)
- an alteration of intestinal immunity, including changes in intestinal permeability
- an alteration in the composition of the gut microbiota: intestinal dysbiosis
- changes in gut-brain nerve communication
What are the causes of irritable bowel syndrome?
The exact causes of IBS are not yet fully understood, but several factors may contribute to its development. These factors include:
- Gut microbiota imbalance : An imbalance in the bacteria present in the gut (dysbiosis) can cause or maintain IBS symptoms. Gut bacteria play an important role in digestion, bowel function, and immune system regulation.
- Food sensitivity : Some people with IBS have food sensitivities, particularly to fermentable foods known as FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides and polyols).
- Stress and anxiety : Stress and anxiety appear to worsen IBS symptoms. The enteric nervous system, which controls digestive functions, is closely linked to the central nervous system, which manages emotions and stress.
- Intestinal infections : Intestinal infections, such as gastroenteritis, can cause changes in bowel function and gut microbiota and trigger IBS symptoms.
- Genetic factors : Some studies suggest that IBS may have a genetic component, meaning you may be more likely to develop the disorder if a member of your family suffers from it.
What are the symptoms of irritable bowel syndrome?
The symptoms of IBS vary from person to person, but the most common are:
- Abdominal pain : Abdominal pain is usually felt as cramps and can be relieved by defecation.
- Bloating and gas : People with IBS may experience excessive bloating and gas.
- Diarrhea and constipation : People with IBS may alternate between diarrhea and constipation, or primarily experience one of these symptoms.
- Sensation of incomplete emptying : People with IBS may feel like they have not completely emptied their bowels after having a bowel movement.
- Mucus in stools : It is common to find mucus in the stools of people with IBS.
How is irritable bowel syndrome diagnosed?
The diagnosis of IBS relies largely on the evaluation of symptoms and the exclusion of other digestive disorders. In IBS, there are no physical lesions; the diagnostic aim is to avoid confusion with other conditions such as:
- lactose intolerance
- celiac disease (gluten intolerance)
- drug-induced diarrhea and laxative abuse
- parasitic infections
- gastroenteritis
- IBD (inflammatory bowel disease)
- small intestinal bacterial overgrowth (SIBO)
- microscopic colitis
The Rome criteria are used to reliably diagnose IBS, as long as there are no alarm signs such as rectal bleeding, weight loss, or other symptoms. Generally, the doctor will order standard blood tests, including liver function tests and possibly screening for markers of the aforementioned conditions.
A colonoscopy may be recommended, particularly to rule out the presence of polyps or tumors of the colon; biopsies are then performed to rule out possible microscopic colitis.
What are the treatments for irritable bowel syndrome?
Treatment for IBS is primarily functional and aims to relieve symptoms and improve quality of life. Treatment options include:
- Dietary changes : Avoiding trigger foods, increasing fiber intake, and drinking enough water can help relieve IBS symptoms.
- Medications : Medications such as antispasmodics, laxatives, and antidiarrheals may be prescribed to relieve IBS symptoms.
- Behavioral therapies : Techniques such as cognitive behavioral therapy, relaxation, and stress management can help reduce the impact of stress and anxiety on IBS symptoms.
- Probiotics : Probiotics, which are beneficial bacteria for gut health and function, can help restore the balance of gut flora and relieve IBS symptoms. It is important to choose high-quality probiotics in sufficient doses.
- Physical exercise : Regular exercise can help reduce stress and improve bowel function.
What is the role of the microbiota in irritable bowel syndrome?
Dysbiosis has been shown to be present in individuals suffering from irritable bowel syndrome. Dysbiosis may contribute to the development of IBS or the maintenance of symptoms.
Changes have been described during IBS, including a decrease in the diversity of the gut microbiota and a change in the proportion of certain bacteria (increase in bacteroidetes and other bacteria including E. coli , and decrease in firmucutes , clostridium , streptococcus and bifidobacterium ).
These changes are correlated with the severity of pain related to intestinal bloating.
Can probiotics improve the symptoms of irritable bowel syndrome?
Probiotics are beneficial for intestinal function and help maintain a good balance of the intestinal microbiota.
These measures are among those implemented to manage intestinal discomfort. In particular, it has been shown in mouse models of IBS that intestinal permeability is present and correlates with visceral hypersensitivity. Probiotic strategies using Bifidobacterium longum and Lactobacillus rhamnosus can improve intestinal permeability. Clinical trials (such as Preston et al., 2018) have also shown that supplementation with several Lactobacillus strains ( acidophilus, casei, rhamnosus ), at a dose of 50 billion CFU per day, leads to an improvement in quality of life, with improvements in stool frequency and texture.
Irritable bowel syndrome in brief
In conclusion, irritable bowel syndrome (IBS) is a chronic digestive disorder that causes abdominal pain, bloating, gas, and changes in bowel function. IBS has a significant impact on the quality of life of those who suffer from it.
Although the exact causes of IBS are not yet fully understood, several factors can contribute to its development, including a strong component related to the gut microbiota. Treatment for IBS aims to relieve symptoms and improve quality of life, and may include dietary changes, medication, behavioral therapies, probiotics, and exercise.
If you think you may be suffering from IBS, it is recommended that you consult a doctor to confirm the diagnosis and then implement measures tailored to your case to relieve the symptoms.
What solutions does Phytocea offer to relieve IBS?
At Phytocea , we have developed Flore Daily . Flore Daily is a probiotic food supplement, highly concentrated (over 50 billion CFU) and containing several varieties of Lactobacillus and Bifidobacterium . Depending on your situation, this complete and unique formula may be helpful for managing IBS and intestinal permeability; however, it is not a universal solution and should be combined with a lifestyle and dietary approach tailored to your individual needs.
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