Irritable Bowel Syndrome

Diet modifications, fiber, probiotics and herbal remedies for common complaints were reviewed by John D McGuire and Philip A Towers.

Intestinal Syndrome (IBS) is a functional, debilitating, multifactorial, and functional gastrointestinal disorder in which a definitive etiquette is not established and no uniform treatment is possible. This condition is very common in developed countries with symptoms of IBS experienced by 8-22% of the population1. Thus, IBS poses a significant economic burden on society and individuals.

IBS is characterized by a combination of signs and symptoms, such as abdominal pain, constipation (IBS-C), diarrhea (IBS-D) - or alternation between the two (IBS-A) consistency of stools, rectal slime due to hypertension colonic mucus, symptoms of symptoms such as anorexia, flatulence, gastro-oesophageal reflux (GOR) and nausea, and emotional components where anxiety and / or depression are frequently noted. Abdominal pain is often relieved after reproduction.

Although some genetic susceptibilities may exist for IBS, there are no biological markers and diagnoses are currently based on symptoms that meet the criteria for Roman II. Initially, the diagnosis for IBS was made based on Criterion Rome I. The previous criteria stated that at least 3 months of abdominal pain, either persistent or recurrent, was relieved by urination or / or was associated with changes in the frequency or consistency of the stool. On the other hand, Criterion Rome II differs from Rom I's stating that abdominal pain should be either continuous, or repeated for 12 weeks or>. Both Roman I & Rome II Criteria are consistent in describing the underlying symptoms, namely, relieving abdominal pain after reproduction, & / or changes related to stool frequency and consistency, but Criterion II II is more specific in prescribing that at least 2 of the accompanying symptoms should be noted, along with abdominal pain. Although Criterion I Rome is also very detailed in determining whether an individual should have 2 or more IBS-related symptoms, e.g., frequency of fungal changes more than 3 days or 25% of the time, the newer Rom II criteria has helped to facilitate the diagnosis of IBS. Where is the pathophysiology patient

IBS can develop from several different mechanisms. Some have been suggested, including abnormal colonic fermentation or gall bladder motions; altered microbial flora; anxiety / depression; bacterial gastroenteritis; the sensory component of an exaggerated gastrocolonic response; food allergy, intolerance or sensitivity; gastro-oesophageal reflux; interruption of transit time or intestinal gas load tolerance; intestinal sensitivity increases; low mucosal inflammation; motility disorders; degeneration of myenteric plexus neurons; oxytocin-threshold increases for perceptual depth; rectal hypersensitivity; and deep hypersensitivity.

Regardless of the mechanism by which IBS develops, symptoms are usually associated with altered intestinal motility, resulting in gas transit and abnormal carcasses.

Conventional treatment

Conventional drug therapy involves the use of antispasmodic / anticholinergic drugs (used to treat gastrointestinal cramps), antidiarrhoeals, laxatives, serotonin receptor agonists (for IBS-C), serotonin receptor antagonists (for IBS-D) and SSRIs for associated anxiety, depression, obesity. -Compulsive and panic disorder. These medicines usually have broad side effects; However, adverse actions and reactions are beyond the scope of this study. There is no universal agreement on the management of IBS. With regard to the conventional approach and education of patients, if advice is offered, it is generally advisable to increase their intake of dietary fiber (for example, wheat bran) or supplement, say, sphincter or psyllium husk. However, some practitioners acknowledge the importance of stress management & counseling.

Diet

Most of the nutrition studies related to IBS have been observed, and only a small fraction are randomized controlled trials. However, they are useful in suggesting treatment options.

Gas, diet and IBS

The daily production of gas in the human gastrointestinal tract (GIT) is 500-1500ml, and the amount found at the given time is 200ml. The five major gases are responsible for the development of the channel, namely carbon dioxide, hydrogen, hydrogen sulfide, methane, and oxygen. The oxygen contained in the GIT is the result of air being swallowed during eating and drinking (aerophagia), or may be due to hyperventilation in cases of anxiety. Larger amounts will be expected in subjects who eat too fast, chew gum, or smoke, as not all are absorbed or expelled following belching.

The human colon is home to at least 400 different species of bacteria, and examples include carbohydrate fermentation bacteria, methane-producing bacteria (methanogens), and pectinolytic bacteria. These bacteria are responsible for the production of carbon dioxide (major gas products), hydrogen, hydrogen sulfide, and methane. Flatus is the product of an accessible substrate (carbohydrate and protein). Examples of these substrates include: beans, cabbage, Brussels sprouts, broccoli, and cereals containing raffinose and fruits, onions and wheat (containing fructose). These non-absorbable carbohydrates, along with sugars such as fructose contained in fruits, dietary starch (which releases small intestinal absorption), such as potatoes, corn, wheat and dietary fiber, such as those in oats, beans, and beans, all of which can produce gas. It is the result of this food being metabolized by the colonic flora, followed by bacterial fermentation.

A number of different treatment options are described in the literature for IBS; However, diet modification is not seen as a priority in many cases. Foods containing sulfur such as beans, broccoli, Brussels cabbage, cabbage, cauliflower, garlic and onions have been identified as extremely flatulogenic. Evidence related to the exclusion of foods containing sulfur is limited and, in many cases, rejecting the diet is excluded, restricted or not proven effective.4.5 However, other studies acknowledge that some foods may play a role in gas production in IBS patients. 3,6-12

Amino acids containing sulfur, cystine, methionine and taurine are the main sources of sulfur diets. Other sources are derived from the glucosinolates found in Brassica vegetables (broccoli, Brussels cabbage, cabbage, cabbage and carrot) .13 In garlic and onions, organic sulfur compounds are found in the form of diallyl thiosulfinates (allicin). Other sources of sulfur food come from meat or food additives used as preservatives (e.g. sulfur dioxide and sodium metabisulfite). Magee et al13 found significant improvements related to the physical sulfate concentration associated with meat intake.

Some oligosaccharides, such as raffinose and stacchiose, appear to be the most important sources of nut digestion, as these compounds cannot be degraded by the intestinal mucosa enzymes.3,14 It may be expected that, after fermentation, these complex carbohydrates contribute to stomach and bloating distances in IBS patients. Again, these patients may only show higher sensitivity because of their reduced gas capacity due to altered motility. Information in the literature is limited to the ability to produce gases containing sulfur and oligosaccharides, and addressing this knowledge gap may be an important step in the treatment of IBS.

------------------