What is it?
Irritable Bowel Syndrome (ISS) is one of the most common diseases of the gastrointestinal tract, and is characterized by chronic and recurrent abdominal pain and discomfort. The cause is usually multifactorial and the estimated worldwide prevalence is 10 to 15%. It may have the first symptoms in childhood, but usually begins to manifest itself in early adulthood. Women are typically more affected than men, at a ratio of 2:1, and about half of those affected seek medical care.
How does Irritable Bowel Syndrome work?
It is a disease with the cause not yet elucidated, but there has already been a very important relationship of the intestine-brain axis. It is observed that psychosocial stressors usually precede the symptoms, and when the patient is treated with therapies directed to the central nervous system, improvement is perceived in the condition. Some possible causes include intestinal motility dysregulation, visceral hypersensitivity, inflammation, deregulated microbiota, food sensitivity, genetics, and psychosocial dysfunction.
How to diagnose Irritable Bowel Syndrome?
The diagnosis is made by the Rome IV criterion. For the patient to be diagnosed with IIS, he must have recurrent abdominal pain on average 1x per week in the last 3 months, with symptomons at least 6 months before diagnosis. Criteria also require the patient to have abdominal pain in combination with at least 2 of the following:
- Defecation (pain improvement or worsening)
- Change in the frequency of faeces
- Change in the shape of feces (appearance).
Treatment of Isis
The main line of treatment is in line with dietary changes in order to reduce FODMAPs, i.e., fermentable oligosaccharides, disaccharides, monosaccharides and polyols, and also lactose reduction. These foods are gas producers, so removing them from the diet reduces gas distension and relieves pain. Some of the foods excluded from this patient’s diet are beans, pork, cabbage, broccoli, Brussels sprouts, wheat germ, high carbohydrate content, fructose, diet gluten. One can evaluate the case and recommend supplementation with probiotics in order to repopulate the gut with beneficial/efficient bacteria and reduce symptoms of swelling.
References
Article: Defrees DN, Bailey J. Irritable Bowel Syndrome: Epidemiology, Pathophysiology, Diagnosis, and Treatment. Prim Care. 2017 Dec;44(4):655-671. doi: 10.1016/j.pop.2017.07.009.
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