Patients with Irritable Bowel Syndrome (IBS) have episodes of abdominal distress and / or pain in combination with bowel habits disorder and bloating. These symptoms affect the quality of life of patients and decrease productivity at work.
Patients with irritable bowel visit physicians more frequently, undergo more diagnostic tests and examinations, consume more drugs, and are hospitalized more often than those who do not have IBS.
They are usually classified into three categories according to their bowel habits. Thus, there is the irritable bowel in which diarrhea prevails (IBS-D), the one where constipation prevails (IBS-C) and the two states alternate (IBS-M).
The etiology of IBS is poorly understood and there is no diagnostic test or effective treatment for it. In recent years, much effort has been made to better understand the pathophysiology of the irritable bowel in order to develop new diagnostic tests and more effective therapies.
Irritable Bowel and Causes
It is already known that genetic / socioeconomic factors, diet, gut microbiome and intestinal inflammation are involved in the etiology of irritable bowel.
Specifically, studies in twins have confirmed heredity, although it has not been identified so far which genes actually increase the risk of the syndrome. In addition, there is no convincing evidence that patients suffer from food allergies or even intolerance to some foods, with the beneficial effect of changing diet attributed to poor carbohydrate and fiber intake.
Regarding the gut microbiome, differences have been reported between patients and healthy people, but they cannot be correlated with specific microbial populations. Intestinal inflammation, finally, plays an important role in a large subgroup of patients with irritable bowel, those who exhibit symptoms after infection (murine irritable bowel).
In recent years it has been recognized by the scientific community that patients with IBS have a disorder in some intestinal cells whose primary function is the production and secretion of chemical transmitters. These cells are called endocrine cells and their numbers are reduced in patients with IBS.
This is attributed to reduced production of endocrine cells by the digestive stem cells as a result of the effect of all the above factors. It is this disorder in endocrine cells that explains the development of visceral hypersensitivity, the disorder in intestinal motility and the secretion of the intestines in patients with irritable bowel.
In the coming years, it seems that research into the irritable bowel will focus on ways in which we can influence the message in the stem cells to restore the number and function of the digestive endocrine cells.
There is a lot of evidence to suggest that glutamine is essential for intestinal function, while its lack inhibits the growth and differentiation of intestinal cells. Its chemical structure provides the cells and the immune cells of the body with the necessary substances (carbon, nitrite) to grow and multiply.
- The possible role of gastrointestinal endocrine cells in the pathophysiology of irritable bowel syndrome. El-Salhy M, Hausken T, Gilja OH, Hatlebakk JG. Expert Rev Gastroenterol Hepatol. 2017 Feb;11(2):139-148.
- Randomised placebo-controlled trial of dietary glutamine supplements for postinfectious irritable bowel syndrome. Zhou Q, Verne ML, Fields JZ, Lefante JJ, Basra S, Salameh H, Verne GN. Gut. 2018 Aug 14.