The Link Between Dietary Components And Functional Gastrointestinal Disorders
A growing body of evidence supports the role of dietary macronutrients in inducing shifts in the GI microbiota, influencing host metabolic and immune markers . Several molecules, either coming directly from food or released by commensals are likely to influence the activity of the immune system .
Diet has been recognized to be involved in the predisposition or exacerbation of IBS, as up to 65% subjects with IBS report food to play a crucial role in their symptoms . Three mechanisms have been proposed to explain the dietary intolerances in individuals with IBS: hypersensitivity to specific foods hypersensitivity to food chemicals and luminal distension.
In this regard, the third mechanism involves a group of food components comprising a category of nutrients defined as fermentable oligosaccharides, disaccharides, monosaccharides and polyols , which are short-chain, soluble, highly fermentable carbohydrates. Their fermentative properties make FODMAPs closely linked to symptoms generation in IBS , increasing the stool bulk with water and fermentation by-products , often resulting in luminal distension, abdominal pain and bloating .
A diet low in FODMAPs is very restrictive and although long-term restrictive diets seem to still allow for an adequate nutrients intake , they may decrease the absolute and relative microbial load and diversity. This can potentially lead to detrimental effects on the colonic environment and microbiota .
Whats The Difference Between Inflammatory Bowel Disease And Irritable Bowel Syndrome
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Receiving a diagnosis from your health care team can be difficult. You may only hear parts of the conversation as your mind starts to think about what treatment will be necessary or how this will affect your daily life.
When receiving a diagnosis related to gastroenterological conditions, misinterpreting the diagnosis can have a radically different meaning between similar-sounding conditions. This is true for inflammatory bowel disease, or IBD, and irritable bowel syndrome, or IBS.
Irritable Bowel Syndrome And Functional Dyspepsia Are Two Common Conditions That Seem To Defy Simple Medical Explanation Since Neither Has A Clear Cause Or A Reliable Diagnostic Test To Identify
Irritable bowel syndrome and functional dyspepsia are two common conditions that seem to defy simple medical explanation. Since neither has a clear cause or a reliable diagnostic test to identify it, theyre considered diagnoses of exclusion. That means a doctor may tell you that you have IBS or functional dyspepsia if your symptoms match and they can rule out other disorders with similar symptoms.
Your provider might also mention that depression and anxiety are common among people who have these digestive disorders.
Now a new study shows that allergies, asthma, and autoimmune disorders like psoriasis and rheumatoid arthritis also tend to overlap with having IBS and functional dyspepsia. According to the study, published in the journal Alimentary Pharmacology & Therapeutics, people who have an allergic or autoimmune condition are significantly more likely to have one of these digestive issues and that the increased risk is independent of psychological distress.
According to the findings, about 20 percent of people with rheumatoid arthritis also have IBS, a chronic disorder characterized by frequent bouts of diarrhea and/or constipation, excess gas, and lower abdominal pain. A substantial number of RA patients have functional dyspepsia, which causes chronic pain, nausea, and bloating in the upper part of the gastrointestinal tract.
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Cytolethal Distending Toxin And Vinculin
Cytolethal distending toxin is a toxin produced by bacteria implicated in food poisoning, including Campylobacter jejuni, E. coli, Shigella, and Salmonella. Cdt causes cell cycle arrest and apoptosis of intestinal cells . It is recognized as foreign by the immune system, resulting in the production of anti-Cdt antibodies.
Vinculin, on the other hand, is a self-protein. It is a membrane cytoskeletal protein that resides within the myenteric ganglia and interstitial cells of Cajal, specialized nerve cells in the intestinal epithelium that regulate gut motility. While the body is normally tolerant of vinculin, anti-Cdt antibodies produced during food poisoning cross-react with vinculin. This cross-reactivity causes the body to mistakenly recognize vinculin as foreign, launching an immune response that culminates in the production of anti-vinculin antibodies.
The sequence of events leading to autoimmune IBS pathology looks like this:
Celiac Disease Symptoms Vs Ibs: How Can You Tell The Difference
Do you feel like your body goes into overdrive when you eat certain foods? Youre not alone. IBS and celiac disease are two different diseases that can cause similar symptoms, so its important to know the difference. By comparing and contrasting symptoms of celiac disease with symptoms of IBS, this blog post may help those who have adverse reactions to food identify what is causing them to feel that way.
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Diagnosis Of Irritable Bowel Syndrome
Diagnosis of irritable bowel syndrome isnt easy. You will need to see your doctor to get expert advice and assessment.
For your doctor to be able to establish if youre living with irritable bowel syndrome or an autoimmune disease , they will need to have a full medical history of you and your immediate family.
Factors such as medication, alcohol and caffeine intake, drug use, diet and exercise regularities and any other health conditions will be taken into consideration for your doctor to make an informed judgement.
If your doctor thinks it is necessary, you may need to provide a stool sample for analysis and possibly blood tests or a colonoscopy.
It isnt as simple as receiving an irritable bowel syndrome test, as one does not exist. Seeking out a diagnosis should be considered if youve been experiencing symptoms of irritable bowel syndrome for longer than 12 weeks.
Symptoms could include changes to bowel movements or abdominal discomfort.
You may also want to get a diagnosis if youre experiencing pains that are unbearable and your overall quality of life is affected.
Subsets Of Ibs Are Caused By Food Poisoning And Autoimmunity
In his research, Dr. Pimentel has found that IBS is characterized by the presence of two autoantibodies: anti-vinculin and anti-cytolethal distending toxin antibodies.
But what exactly are vinculin and cytolethal distending toxin? Why does the body create antibodies to these molecules, and how do the antibodies contribute to IBS?
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The Connection Between The Digestive System And Autoimmune Diseases
An autoimmune disease is a disease that changes the way the human body views a specific part or feature of the body. It can actually cause the body to change its immune response and to send blood cells to fight off an infection that does not exist. Many people today do not realize that there is a like between the digestive system and autoimmune diseases. This connection can occur because the foods people eat cause an abnormal reaction or because they cannot process certain types of food. An integrative medicine physician can help you learn more about these conditions.
A Microbial Signature Of Ibs
In the GI tract, the most abundant phyla are Firmicutes and Bacteroidetes, but Actinobacteria, Proteobacteria, Verrucomicrobia and the less represented Fusobacteria, Tenericutes, Spirochaetes and Cyanobacteria are also present . The microbial composition changes across the different regions of the GI tract, with a predominance of Firmicutes in the proximal colon and Bacteroidetes in the distal colon .
The health-associated patterns of microbial colonization of the GI tract are difficult to define, as everyone can harbor functional and distinctive variants of microbial composition, reflecting early-life events such as mode of delivery, type of feeding and gender . Generally, a âhealthyâ microbial signature is characterized by a prevalence of Firmicutes and Bacteroidetes and a general lack of Proteobacteria .
Other alterations have been generally described in IBS, including an increase in the relative abundances of pathobionts, such as Veillonella , and Enterobacteriaceae, Bacteroides or a decrease in Prevotella and Desulfovibrionaceae . Desulfovibrionaceae include sulfur-reducing bacteria that compete with methanogens for hydrogen disposal in the human colon . Overall, differential relative abundance of taxa from the Bacteroidetes phylum and Ruminococcaceae or Lachnospiraceae families have been reported across studies .
Table 1. Main differences in fecal microbiota composition between IBS subtypes.
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Connections Between The Digestive System And Autoimmune Diseases
Inflammation is the main connection between autoimmune diseases and the digestive system. When you eat certain poorly digested foods, swelling will develop within your internal organs. Your autoimmune system then views that inflammation as a toxin or a disease that it needs to treat. It attacks that organ to stop the inflammation but actually makes the swelling worse. Red meat, dairy products, wheat, and alcohol are great examples of items that cause inflammation. When you suffer from a common digestive issue and eat a slice of pizza with a glass of wine, your intestines may begin to swell hours later. As the body fights back, the swelling can worsen.
You can also suffer from any of these conditions because of a lack of good bacteria in your digestive tract. While many people assume that all bacteria is bad bacteria, the human body actually relies on some types of good bacteria in order to absorb essential nutrients and have a strong immune system. A healthy balance of good bugs within your digestive tract keeps your bowel movements regular and helps you healthy. Taking a laxative or antibiotics can be quite harmful to your digestive system since many good bacteria are eliminated from your body. Your immune system will then send more agents to fight the bad bacteria, which can leave you feeling sick. Even consuming an unhealthy diet can eliminate the good bacteria from your body.
Diet And Nutrition For Ibs And Ibd
IBD and IBS are not caused by diet. However, diet can affect symptoms. Paying attention to what is eaten may go a long way toward reducing symptoms and promoting adequate nutrition. Both IBD and IBS may lead to malnutrition of certain nutrients. This is due to the likelihood of the increased transit time of bowel movements for each condition. Therefore, it is important to address nutrient needs as part of an effective IBS and IBD treatment approach.
There is no one diet to follow for either IBS or IBD, but here are a few helpful suggestions when considering what to eat:
- Slow down while eating don’t rush through meals
- Try eating smaller meals more often throughout the day
- Avoid foods that trigger symptoms like bloating, diarrhea, abdominal pain, and cramping
- Try incorporating more omega-3 fatty acids as they may have an anti-inflammatory effect
- Consider nutritional supplements if your appetite is poor and solid foods aren’t tolerated well
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Is Surgery Ever Used To Treat Inflammatory Bowel Disease
Surgical treatment for IBD depends upon the disease. Ulcerative colitis, for instance, can be cured with surgery, because the disease is limited to the colon. Once the colon is removed, the disease doesn’t come back. However, surgery will not cure Crohn’s disease, although some surgeries may be used. Excessive surgery in people with Crohn’s disease can actually lead to more problems.
There are several surgical options available for people with ulcerative colitis. Which one is right for you depends on several factors:
- The extent of your disease
- Your overall health
The first option is called a proctocolectomy. It involves the removal of the entire colon and rectum. The surgeon then makes an opening on the abdomen called an ileostomy that goes into part of the small intestine. This opening provides a new path for feces to be emptied into a pouch that’s attached to the skin with an adhesive.
Even though surgery will not cure Crohn’s disease, about 50% of people with Crohn’s require surgery at some point. If you have Crohn’s disease and need surgery, your doctor will discuss your options with you. Be sure you ask questions and understand the goal or goals of the surgery, the pros and cons, and what could happen if you don’t have the surgery.
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Pediatric Gastroenterologist Dr Varier Explains What Parents Need To Know About Inflammatory Bowel Disease And Irritable Bowel Syndrome
Youre not alone if you find the terms inflammatory bowel disease and irritable bowel syndrome confusing. And the fact that most doctors refer to these two conditions as a jumble of letters – IBD and IBS – doesnt help matters. Both disorders affect the bodys gastrointestinal tract or digestive system. Both IBD and IBS can have overlapping symptoms, like belly pain or diarrhea. And I often find that both terms are sometimes used as a blanket term to describe specific symptoms or even used interchangeably.
IBD Versus IBS What Is the Difference?
But IBD and IBS ARE two very distinct gastrointestinal disorders. Every day I talk to pediatric patients and their parents who come to my GI clinic for answers. Their questions and concerns may stem from the struggle to figure out what is going on with their child or the worry about persistent symptoms. Their childs symptoms may be worsening and starting to impact school and other activities of daily life.
I find that educating patients and their families is an essential part of the diagnosis and treatment process for managing both IBD and IBS. Lets start here with a breakdown of both conditions.
Inflammatory Bowel Disease, or IBD
IBD is considered a rare disease, affecting only 0.1% of children. IBD is also an autoimmune disease, which means your immune system wrongly attacks a part of the body. Two of the most common GI autoimmune conditions we diagnose and treat are Crohns Disease and Ulcerative Colitis .
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What Is Irritable Bowel Syndrome
IBS is a common condition that can affect your bodys digestive system which can lead to some common symptoms like bloating, gas, diarrhea, constipation and feeling generally unwell.
Normally, these symptoms are more present after eating and often are soothed after a bowel movement .
It is a condition that needs further research as specific causes and treatments are not entirely confirmed.
However, several different things may be involved: disordered interaction between the nerves linking the brain and the gut, development of IBS following a viral or bacterial gastroenteritis, microbial alterations within the normal gut flora and motility issues.
It can often be triggered by certain foods or life events that are stressful and currently there is no cure for IBS. Several management strategies are available to reduce and alleviate symptoms.
Medical journals noted other common potential causes like psychological factors , lactose or gluten intolerance, food allergies and inflammation in the gastrointestinal tract.
Learn more in the in-depth article: What is IBS Disease?
What Are The Symptoms Of Celiac Disease
In general, celiac disease symptoms may be mistaken for food allergies or lactose intolerance but the difference with gluten exposure is that these symptoms often appear some time after a meal rather than immediately after eating the food.
- Abdominal bloating that can turn into severe pain and discomfort, especially after eating a meal or snack high in gluten
- Malnutrition from malabsorption of nutrients, especially vitamin D and calcium, because an autoimmune reaction to gluten exposure has damaged the small intestine. Symptoms often include fatigue, weight loss, anemia and poor growth in children.
- Diarrhea or constipation
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Ibs: No Longer A Disease Of Exclusion
Due to a lack of validated diagnostic biomarkers, an IBS diagnosis has historically been given only when other gastrointestinal conditions have been ruled out. This process costs patients thousands of dollars in medical expenses while at the same time failing to provide any useful direction regarding treatment.
The problem of how to effectively diagnose and treat IBS has puzzled clinicians for decades. However, thanks to the research of Dr. Mark Pimentel, we may now have some answers.
Dr. Pimentel, an associate professor of medicine at Cedars-Sinai Medical Center, has made it his lifes work to better understand IBS and small intestinal bacterial overgrowth . He and I previously discussed SIBO on my podcast, Revolution Health Radio. Recently, I had the honor of hosting Dr. Pimentel again on the show. This time, we discussed his groundbreaking research indicating that diarrhea-predominant IBS and IBS that is predominantly characterized neither by diarrhea nor constipation, or mixed IBS , are triggered by food poisoning, resulting in the production of antibodies that damage the enteric nervous system and trigger IBS.
What Is Ulcerative Colitis
Ulcerative colitis is another type of IBD. Its also an autoimmune disorder. Unlike Crohns disease, ulcerative colitis only involves the colon, or large intestines. It only affects the inner lining of the colon, instead of the whole wall thickness.
What are symptoms of ulcerative colitis?
Symptoms of ulcerative colitis include:
-
Bloody or mucousy diarrhea
These complications may need surgery to treat them.
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Common Symptoms You May Experience With Inflammatory Bowel Disease Are:
- Urgent bowel movements
- Cramping abdominal pain
Symptoms of inflammatory bowel disease may be experienced regularly and can significantly affect your quality of life. The treatment for inflammatory bowel disease is multifactorial. Treatment typically involves using immunosuppressive drugs to help the immune system avoid attacking the bowel. Dietary modifications can decrease inflammation.
Expert Explains How Inflammatory Bowel Disease Irritable Bowel Syndrome Differ
LA CROSSE, Wis. Receiving a medical diagnosis can be difficult. You may only hear parts of the conversation as you start to think about what treatment will be needed and how this will affect your daily life. It can be especially challenging when different diseases have names that sound similar, such as inflammatory bowel disease, or IBD, and irritable bowel syndrome, or IBS. Daisy Batista, M.D., a gastroenterologist at Mayo Clinic Health System-La Crosse, explains the difference between the two diseases.
Inflammatory bowel disease is a group of autoimmune diseases that include ulcerative colitis and Crohn’s disease. In inflammatory bowel disease, the immune system attacks the bowel and causes inflammation, Dr. Batista says.
Inflammatory bowel disease may be triggered by a combination of a genetic predisposition and an illness or exposure to something in your environment that causes the immune system to attack the bowel and create inflammation, Dr. Batista says. There are two peak times for diagnosis in adults: people in their early 20s to 30s and people in their 50s and 60s.
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