IRRITABLE BOWEL SYNDROME

IBS-D or irritable bowel syndrome with prevalent diarrhea

Irritable Bowel Syndrome, commonly known as IBS is one of the most common bowel problems, affecting about 15-20% of the population and usually affecting twice as many women as men.

It is a condition characterized by intestinal pain and/or discomfort generally associated with changes in bowel habits, the causes of which may be varied and difficult to identify. It must certainly be considered that intestinal activity is intimately and directly linked to the brain and emotional states; therefore, the causes of IBS may certainly include a psychological component.

However, like all syndromes, IBS presents itself as a complex of symptoms that vary from patient to patient. For a correct diagnosis of IBS, reference is generally made to the guidelines known as the ‘Rome criteria’ drawn up by the Rome foundation, an international non-profit academic research organization that for almost 20 years has been collecting data and providing educational support to improve the diagnosis and treatment of Functional Gastrointestinal Disorders.

According to these guidelines, IBS has to be diagnosed when abdominal pain or discomfort is present for at least one day per week in the last three months, associated with two or more of the following:

Relief after evacuation
Change in the frequency of evacuations

Change in stool appearance

If these symptoms are associated with ‘alarm bells’ such as blood in the stools or pain that is not relieved after evacuation, it is advisable to carry out more in-depth analyses to assess the presence of chronic intestinal inflammation, also referred to as IBD.

The most prevalent subtype of IBS, according to the scientific literature, is the so-called IBS- D, i.e. Irritable Bowel Syndrome with diarrhea, characterised by soft, unformed stools in more than 25 per cent of defecations.

Although there is no real cure for IBS-D, it is still possible to greatly improve one’s quality of life and feel better by adopting the right behavioral norms in the following areas:

Balanced diet and elimination of food stimuli that may worsen diarrhoeal symptoms, following the instructions of a nutrition professional
Stress management and psychological component also through possible psychotherapy

In order to identify the most suitable behavior for one’s case, one must rely on the right specialists who, in the case of severe symptoms, will evaluate the prescription of anti-diarrheal drugs or anti-spastic drugs that act on pain by slowing down or normalizing abnormal bowel movements.

Regarding the use of probiotics, experts disagree on the overall benefit of their use in cases of IBS-D. They are sometimes recommended with the aim of modifying the composition of the gut microbiota in order to reduce discomfort, abdomen, bloating and gas from IBS-D. However, most probiotic mixtures are unable to make a real contribution to symptom management.

A real benefit, on the other hand, may be provided by the supplementation of bacteria capable of producing butyrate directly in the colon.

How to manage IBS-D

Butyrate and butyrate-producing

Butyrate and butyrate-producing bacteria for colon well-being

A new approach in the management of IBS-D considers butyrate for its important role in improving the gastrointestinal symptoms associated with this condition.

Butyrate is a short-chain fatty acid naturally produced by the gut microbiota when it ferments dietary fires. It serves as the main source of nutrition for colonocytes (colonic epithelial cells), providing them with approximately 75% of the energy they need for survival and well-being.

Butyrate is also believed to have several beneficial effects on gut health, including regulating inflammation and protecting the intestinal mucosa.

Lack of butyrate in the intestine can lead to colonocyte distress and consequent intestinal inflammation, with also a decreased ability to reabsorb sodium and water, which seems to lead to more frequent diarrheal discharges.

Unfortunately, a shortage of butyrate-producing bacteria has been noted in the gut of individuals with IBS-D, and supplementation of these specific microorganisms could generate an important benefit.

Currently, of the butyrate-producing bacteria, the most efficient within the body are Faecalibacterium prausnitzii and Clostridium butyricum. The latter is characterised precisely by the large amount of butyrate production, as its name testifies.

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