Irritable bowel syndrome (IBS)

It is a chronic and frequent intestinal syndrome (group of symptoms) that affects more than 15% of the population, which limits greatly the quality of life of the sufferer.

ABOUT THE IRRITABLE BOWEL

Irritable bowel symptoms

Irritable Bowel Syndrome (IBS), popularly known as irritable bowel is a functional disorder characterized by the presence of recurrent abdominal pain associated with abdominal bloating, flatulence (passage of gas) and depositional rhythm disturbances, as well as in the form of diarrhea, constipation or both.

It is a chronic and frequent intestinal pathology that affects more than 15% of the population, greatly limiting the quality of life of the sufferer.

It is a problem that affects the entire intestine, not just the colon. It usually shows up with more or less frequent relapses, without a basic pathology that explains it.

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Irritable Bowel Syndrome (IBS) has a high prevalence

It affects more women than men

Fundamentally/basically between 20 and 50 years Although it can be diagnosed in people of all ages, especially in adults

In Spain it affects more than 10% of the population

IBS Subtypes
There are 3 subtypes

Its incidence decreases significantly above the age of 65

IBS-C

Irritable bowel with constipation. It affects women more

IBS-D

Irritable bowel with diarrhea. More frequent in men

IBS-M

Mixed Irritable bowel that alternates periods of constipation with periods of diarrhea

Irritable Bowel causes

Despite the intense research that has been carried out on irritable bowel, its cause is not yet known, and there are no specific tests to diagnose it.

It´s known that it is a multifactorial disorder in which various factors influence the appearance of symptoms, but it is not yet well known how to properly organize the pieces of this complicated puzzle:

All of this is related to a functional alteration of the intestinal barrier which can cause harmful effects by allowing the contact of pathogens and irritants, usually present in the intestine, with the innermost layers of the intestinal wall, irritating it and modifying the composition and balance of the gut microbiota.

INTESTINAL BARRIER FUNCTION

The surface of the intestinal mucosa is lined with epithelial cells that establish an effective barrier between the internal environment (organism) and the external environment, preventing the passage of potentially harmful substances.

The gut has developed the intestinal barrier, a defensive system composed of different cellular and extracellular elements, which act in a coordinated way as a filter to:

Prevent the passage of toxins, antigens and pathogens.

Maintain the proper development of the epithelial barrier, the immune system,

Maintain the acquisition of tolerance towards diet antigens and gut microbiota.

The intestinal barrier is composed of different elements, representing different levels of protection, which depending on their location and nature, are grouped into extracellular and intracellular elements.

Extracellular elements

The mucus layer, which as a "microclimate" covers the intestinal epithelium, rich in mucin. It works as a physical barrier coverin and protecting the cells of the intestinal epithelium.
The peristalsis exerted by the muscular/muscle layers of the intestine that evacuates the contents of the intestine, regulating their time of permanence and therefore of the possible toxic substances and pathogenic microorganisms present in the lumen of the intestine.

Cellular Elements

The gut microbiota, located on the outermost part, is one of the essential components of the intestinal barrier. It limits colonization by pathogens by competing for the ecological niche and nutrients, maintaining the pH of the area and producing antimicrobial substances.
The intestinal epithelium cells themselves and the different types of junctions that allow them to remain assembled together.

PHYSIOPATHOLOGICAL MECHANISM

The pathophysiological mechanisms of the irritable bowel are currently unknown. However, It seems to be that there is something in common among the 3 different clinical types (diarrhea, constipation and mixed) and it is the increase in intestinal permeability.

When the integrity of the intestinal barrier is damaged in one way or another, its permeability is altered, and the transit of pathogens could irritate the intestinal wall and modify the composition and balance of the microbiota.

Microbiota Integrity

The gut microbiota is made up of more than 100 billion living microorganisms (mainly bacteria, but also fungi and viruses), ten times more than the number of cells of the human body.

This whole community of microorganisms lives in harmony with the human organism, in a mutually beneficial relationship (symbiosis).

The integrity, diversity and balance of this microbiota can be frequently altered by various factors: diseases, treatment with antibiotics and other medications, physiological disorders of the intestine, stress, travel, changes in diet, age, infection and colonization of the intestine by pathogens (viruses, bacteria, parasites, fungi, ...), etc.

The wall of the intestine plays an important role in the symptoms of the irritable bowel. The disturbance of the gut microbiota can lead to a lack of integrity of the intestinal wall and allow pathogens and irritants elements, normally present in the intestine, to have a non-physiological contact with the intestinal mucosa, damaging it.