Le Syndrome de l’Intestin Irritable (SII)

Or Irritable Bowel Syndrome (IBS)

Definition

Irritable Bowel Syndrome (IBS) is a chronic gastrointestinal disorder. It is considered a functional digestive disorder because it affects certain functions of the body, such as bowel movement. However, individuals with IBS generally do not exhibit any structural, biochemical, or histological irregularities.

Etiology

The exact cause of IBS is unknown. Different psychosocial and physiological factors could be involved. These factors include alteration in the enteric nervous system, intestinal hypersensitivity, abnormal gastrointestinal motility, disturbances in the interaction between the brain and the intestine, mild inflammation, activation of the immune system, increased intestinal permeability and alteration of the intestinal microbiota.

 Symptoms 

Symptoms of IBS may include chronic abdominal pain, altered bowel movements (diarrhea and / or constipation), a feeling of incomplete evacuation, abdominal distension, bloating, gas, and mucus in the stool. Symptoms can be triggered by certain foods or emotions (eg stress, anxiety, etc.). Symptoms can also be variable within the same individual and between individuals.

Diagnostic 

The diagnosis of IBS is based on the presence of standardized symptoms, called the Rome criteria, and the exclusion of other conditions.

Rome criteria

The diagnosis of IBS according to the Rome criteria is made in individuals who have experienced abdominal pain for at least one day per week in the past three months, with at least two of the following:

  • Pain associated with defecation
  • Pain related to changes in the frequency of bowel movements (diarrhea and / or constipation)
  • Pain related to the change in stool consistency

Exclusion of other pathologies

It is also important to perform additional tests to rule out other conditions that are related to IBS, such as celiac disease, Crhon disease, diverticular disease, lactose intolerance, intestinal cancer, etc. These tests are especially important in individuals who have certain warning signs, such as rectal bleeding or anemia, nocturnal bowel movement, unintentional weight loss, persistent diarrhea every day, recurrent vomiting, old age or fever.

Classification

There are four subtypes of IBS, classified according to the predominant transit: IBS with predominantly constipation (IBS-C), IBS with predominantly diarrhea (IBS-D), IBS with the presence of constipation and constipation. alternating diarrhea (IBS-M, mixed) and unclassified IBS in the absence of sufficient criteria.

Nutritional treatment 

Nutritional treatment for IBS varies from person to person depending on the symptoms (eg, diarrhea, constipation, etc.) and the elements that seem to trigger them (eg, foods and emotions). Depending on the individual, treatment may include a change in diet, an exclusion diet (eg: FODMAP), change in fiber intake, supplements, probiotics and prebiotics.

Dietary recommendations

Depending on the symptoms and their triggers, dietary recommendations may include:

  • Increase the intake of dietary fiber and hydration, especially in the presence of constipation
  • Split meals and avoid drinking heavily with meals
  • Eat at regular times and not skip meals
  • To eat slowly and chew well
  • Reduce gas-producing foods and habits that may promote aerophagia (eg: drinking through a straw or chewing gum), especially in the presence of bloating and gas
  • Avoid foods high in fat
  • Avoid or reduce gastrointestinal stimulants (eg: caffeine, nicotine, alcohol), especially in the presence of diarrhea
  • To promote regular physical activity and stress reduction
  • Maintain an elimination routine (eg: FODMAP).

Finally, it is important to remember that dietary recommendations should always be personalized in order to meet the specific needs of each individual.

 

References

 

 

 

Article written by:

Marie-Noël Marsan, Nutritionist

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