2023-06-08 18:01:14
As many as 45 million Americans suffer from a condition that sufferers grudgingly mention “irritable bowel syndrome,” which, despite its prevalence, is still somewhat of a mystery when it comes to who (two-thirds of patients are women) and why.
But scientists invariably grapple with this habitual behaviour. Newer therapies target pathways that appear to be associated with cramps, bloating, gas, diarrhea or constipation that disrupt patients’ daily lives.
Irritable colon
Irritable bowel syndrome (IBS), which is characterized by symptoms of chronic abdominal pain and variable bowel movements, is classified into 3 types, according to which symptoms prevail: Diarrhea (IBS-D) or Constipation (IBS-C). “,” or “a combination of these symptoms.” It is one of the most common gastrointestinal conditions, affecting up to 15 percent of Americans, according to the International Digestive Disorders Foundation.
Irritable bowel syndrome is what doctors call a “functional bowel disorder.” Because it affects the way the digestive system works, it is not caused by any obvious structural or structural problem. But Harvard experts say this classification is problematic.
“Saying there is nothing wrong is wrong,” says Dr. Anthony Limbaugh, a gastroenterologist at Harvard-affiliated Beth Israel Medical Center. Because clearly something is different. The only thing is that our standard clinical tests can’t reflect that.
coercive effects
The causes of IBS remain frustratingly unclear, but the symptoms are thought to stem from a wide variety of factors. of between it…
Changes in the gut microbiota. This group of gut microbes is affected by what we eat and drink, as well as by disease. “About 10 percent of people who get a gastrointestinal infection, whether it’s viral, bacterial or parasitic – even the (Covid) virus – have a higher rate of (irritable bowel syndrome),” says Dr. Limbaugh.
* Twisted bowel muscle contractions. These contractions push food through the digestive tract normally, at a faster or slower rate than is normal for people with IBS.
Defective nerve signals. Normal digestion depends on clear communication between the brain, gut, and nervous system. However, these signals are disrupted when irritable bowel syndrome occurs.
Pelvic floor problems. This is especially true for women whose pelvic muscles do not normally relax, which can lead to chronic constipation.
Early life stressors. This can include traumatic events during childhood.
* Genetic Disease. People with a family history of irritable bowel syndrome are also more likely to develop it.
At best, irritable bowel syndrome is an extremely annoying event that forces people to schedule their food according to their toilet needs. At worst, it can be a handicap; This causes great distress and places restrictions on people’s ability to work and travel.
“All the data shows that the suffering is very great,” says Dr. Limbaugh. It’s a disorder that we know can really debilitate people.”
Selected treatments
For the first time, guidelines for the treatment of irritable bowel syndrome, updated in June 2022 by the American Gastroenterological Association, guide clinicians on how to personalize patients’ treatment with a wide range of medications.
Over-the-counter medications — including fiber supplements, laxatives (in limited amounts), and antidiarrheals — can help control symptoms. But recent years have brought an influx of drug options for IBS that don’t just treat the symptoms, but instead target specific biochemical or cellular pathways to slow the movement of food through the intestines, or push fluids into the intestines to soften waste and speed its passage. For irritable bowel syndrome (diarrhea), these medications include alosetron (Lotronex) and eluxadoline (Viberzi). For “irritable bowel syndrome (constipation),” these medications include lubiprostone (Amitiza), linaclotide (Linzess), plecanatide (Trulance) and tenapanor (Ibsrela).
The antibiotic rifaximin (Xifaxan) appears to be beneficial to the gut microbiota by inhibiting “bad” organisms that contribute to IBS symptoms, says Dr. Lawrence Friedman, assistant chief of medicine at the University of Massachusetts General Hospital. Harvard and chief of medicine at Newton Wellesley Hospital, who added, “It’s one of the most exciting recent developments.”
Doctors are also making use of old medicines for new purposes. Dr. Limbaugh says that many antidepressants can alter the activity of nerve signals in the gut or reduce the pain of irritable bowel syndrome.
proper diet
While a variety of medications can help relieve symptoms, effective measures for IBS depend on diet and lifestyle changes. Avoiding trigger foods, eating more fiber, drinking plenty of fluids, exercising regularly and getting enough sleep can help control mild symptoms in many people. Symptoms may also worsen depending on the foods you eat. Wheat, dairy products, citrus fruits, beans, cabbage, and soft drinks. At the same time, peppermint oil supplements, taken as coated tablets, can relieve bloating and pain.
“Many people also find that lactose can be a trigger, and if they drink a glass of milk or consume other dairy products, their symptoms get worse,” says Dr. Limbaugh. But sometimes it’s more subtle than that. Even drinking a cup of sugar-free beverage can cause gas and bloating.
For those with severe gas and bloating, a “low-FODMAP” diet (short-chain carbohydrates that are poorly absorbed by the small intestine (fermentable oligo-, di-, and monosaccharides and polyols) may help). “Foods that increase gas production include beans, onions, celery, carrots, raisins, bananas, apricots, peaches, cabbage, Brussels sprouts, wheat germ, pretzels, and cakes. Dr. Limbaugh suggests eliminating” FODMAPs” temporarily and then slowly add each type back into your diet to find the “worst offenders.”
in general; “The range of treatments has expanded,” says Dr. Friedman. We have more tools to work with, and there is a higher probability of success, but there may be an element of trial and error.”
* «Harvard Letter – Monitoring Women’s Health» – «Tribune Media» services
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