One in ten Italians suffers from it. Some foods with high fermentative power favor intestinal disorders such as abdominal pain and cramps, bloating, bloating, diarrhea or constipation
In the past the irritable bowel syndrome or Ibs (from the English Irritable Bowel Syndrome), which affects one in ten people in Italy, was classified as a psychosomatic disease, because it was believed that the arrival of that typical stomach ache that communicated to a subject that he was stressed depended on the brain. Today, after decades of research, it is understood that at the origin of Ibs there are also organic alterations, which depend on the diet, the microbiota and the axis between the brain and the intestine, two organs that communicate constantly. For this reason, pathologies such as IBS are now no longer defined as functional, but rather of the brain-intestine axis, which is altered in patients, he explains John Barbaraprofessor of internal medicine and gastroenterology at the University of Bologna.
How does diet affect this disease?
Some foods with high fermentative power called Fodmaps can cause or worsen the intestinal disorders characteristic of irritable bowel: abdominal pain and cramps, bloating, bloating, diarrhea or constipation predominantly, or alternating between them. In contact with the microbiota (the set of intestinal bacteria, ed) these foods ferment and produce gases and substances that annoy the intestines. To name a few: garlic, onion, artichokes, asparagus, apples, pears, persimmons, apricots. For this the specialist can prescribe a diet that is low in FODMAP foods.
Does the suggested diet in turn impact on the microbiota?
Exactly: foods can change the composition of bacteria, viruses and fungi that live in the intestine. If out of balance, the microbiota can induce inflammation and alteration of the permeability of the epithelial barrier.
What is the epithelial barrier?
The epithelium is a large absorbent surface of the intestine which allows the absorption of nutrients but, at the same time, prevents the passage of microbes. The epithelium of an irritable bowel becomes hyperpermeable: the junctions between one epithelial cell and another loosen and begin to pass substances that they shouldn’t. These substances stimulate inflammation which contributes to the change of the microbiota and the manifestation of symptoms; the brain gets the message to send the pain signal. The interdependent diet-microbiota-intestine-brain mechanism: when one element is decompensated then the others jump too.
Does serotonin also play a role in these mechanisms?
Serotonin is a neurotransmitter that is very important in regulating digestive functions. 95% produced in the intestine and 5% in the brain, where it helps to modulate mood. In some patients, an excess of serotonin can promote diarrhea, a deficiency can instead be associated with constipation.
What to expect in the future?
There will be news about microbiota transplant for which Bologna and Rome are centers approved by the ministry. The intervention consists in isolating the microbiota-rich material from the intestines of healthy and super-selected donors and transfusing it into the colon of a patient. Today a lifesaver for those with a serious infection: Clostridium difficile. The next step will be to identify beneficial bacterial populations and create tablets for targeted treatment.
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The diet must not be improvised: each person has their own microbiota which feeds mainly on vegetable fibers from whose fermentation it creates substances, such as short-chain fatty acids, which are important for regulating intestinal function.
Gut health
Seems like a contradiction, but The Low-Fodmap diet limits your intake of fruits and vegetablesspecifies the gastroenterologist Barbara. Relieves symptoms, but depletes the microbiota, which no longer finds that substrate useful for growing. For this important do not self-prescribe it, but always rely on a specialist who modifies and integrates it over time so that you are not deficient in valuable nutrients
. For example, apples and pears can be replaced with kiwi which does not ferment and still provides the ideal nutrients to allow the microbiota to develop.
February 17, 2023 (change February 17, 2023 | 10:15 am)
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