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IBS, SIBO, IBD... Understanding chronic intestinal problems

IBS, SIBO, Crohn’s disease … There are many people who suffer regularly from intestinal problems. What are the symptoms and causes of these chronic conditions of the digestive system? And what can you do about them?
Woman suffering from IBS or SIBO type pain
Discover the similarities and differences between IBS, SIBO and IBD.
Rédaction Supersmart.
2020-08-03Commentaires (0)

IBS (Irritable Bowel Syndrome)

What are the symptoms of IBS?

Irritable Bowel Syndrome (IBS), or functional colopathy, is a problem of the digestive tract which causes chronic abdominal pain. Manifesting as spasms or cramps, this pain is normally accompanied by uncomfortable bloating and dysfunctional transit (diarrhea or constipation).

Between 5% and 15% of the population are thought to suffer from the syndrome. It is more common among women, with 2-3 females affected for every male (1).

This increased sensitivity of the gut causes considerable discomfort in those affected, both physiologically and psychologically. IBS may also result in headaches, fatigue, a sense of isolation, sleep problems, sexual dysfunction, etc. (2)

This functional bowel disorder is nonetheless benign: it neither increases the risk of bowel cancer nor appears to lower life expectancy.

Causes of IBS

Depending on the individual, IBS appears to be caused by:

Episodes of IBS are normally triggered by one or more of the following factors:

How can IBS be managed?

There is currently no definitive treatment for IBS, but there are ways of reducing the frequency and intensity of symptoms. We would advise anyone suffering from IBS to consult their GP, who will be able to diagnose their problem and potentially prescribe suitable medication (anti-diarrheal drugs, laxatives, anti-depressants to block pain perception, etc.)

In addition, the general advice for IBS-sufferers is to:

SIBO (Small Intestinal Bacterial Overgrowth)

What are the symptoms of SIBO?

SIBO stands for Small Intestinal Bacterial Overgrowth. We know that the adult digestive system contains a wide range of microorganisms known as the gut microbiota. This microflora is essential not only for digestion but for our health in general. In someone with SIBO, the problem is that too many bacteria develop in the small intestine.

Their unwelcome presence triggers premature initiation of the food-fermenting process, which increases the production of intestinal gases: hydrogen, methane ... Like IBS, SIBO thus manifests in bloating, flatulence, digestive spasms, reflux or transit problems.

In addition, this disease usually causes deterioration to the intestinal wall, impaired carbohydrate digestion and poor absorption of nutrients (responsible for many deficiencies), as they get taken up by the bacteria. Again like IBS, SIBO can also give rise to a series of additional problems: chronic fatigue, depression, difficulty concentrating...

It’s important to say that this gut flora disorder is widely under-diagnosed, as there is little awareness of it among doctors, apart from in English-speaking countries (10). In France, it has been publicised by journalist and blogger Dora Moutot through her book À fleur de pet - le 1er livre sur la maladie des hyperballonnés qui ont le microbiote à l'envers (‘Fit to burst - the first book on the condition that causes extreme bloating in those with an upside-down microbiota’) (2019) (11).

Causes of this bacterial proliferation in the small intestine

SIBO may be initiated by:

What can you do about SIBO?

Those who think they may have SIBO are advised to consult their doctor for a confirmed diagnosis and potential prescription of antibiotics to try and stem the spread of bacteria. There are also a number of natural approaches to consider:

IBD: Crohn’s disease and ulcerative colitis

What are the symptoms of IBD?

Let’s end this overview of chronic intestinal problems by looking at IBD – Inflammatory Bowel Disease.

The term IBD covers two similar but distinct conditions: Crohn’s disease (or regional ileitis) and ulcerative colitis.

Both involve inflammation of the lining of the digestive tract. In ulcerative colitis, the inflammation more specifically affects the rectum and bowel. IBD can cause abdominal discomfort, recurrent diarrhea or even anal abscesses.

It also increases the risk of developing colorectal cancer(22).

Causes of Crohn’s disease and ulcerative colitis

Incidence of IBD has been on the rise since 1945. This may be due to:

What can you do to address IBD?

Again, there is no real treatment for IBD. It is more a question of management:

References

  1. Kim YS, Kim N. Sex-Gender Differences in Irritable Bowel Syndrome. J Neurogastroenterol Motil. 2018;24(4):544-558. doi:10.5056/jnm18082
  2. Sørensen J, Schantz Laursen B, Drewes AM, Krarup AL. The Incidence of Sexual Dysfunction in Patients With Irritable Bowel Syndrome. Sex Med. 2019;7(4):371-383. doi:10.1016/j.esxm.2019.08.010
  3. Moayyedi P, Andrews CN, MacQueen G, et al. Canadian Association of Gastroenterology Clinical Practice Guideline for the Management of Irritable Bowel Syndrome (IBS). J Can Assoc Gastroenterol. 2019;2(1):6-29. doi:10.1093/jcag/gwy071
  4. Varjú P, Farkas N, Hegyi P, et al. Low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) diet improves symptoms in adults suffering from irritable bowel syndrome (IBS) compared to standard IBS diet: A meta-analysis of clinical studies. PLoS One. 2017;12(8):e0182942. Published 2017 Aug 14. doi:10.1371/journal.pone.0182942
  5. Caviezel D, Maissen S, Niess JH, Kiss C, Hruz P. High Prevalence of Vitamin D Deficiency among Patients with Inflammatory Bowel Disease. Inflamm Intest Dis. 2018;2(4):200-210. doi:10.1159/000489010
  6. Bundy R, Walker AF, et al. Turmeric extract may improve irritable bowel syndrome symptomology in otherwise healthy adults: a pilot study. J Altern Complement Med. 2004 Dec;10(6):1015-8
  7. Moayyedi P, Andrews CN, MacQueen G, et al. Canadian Association of Gastroenterology Clinical Practice Guideline for the Management of Irritable Bowel Syndrome (IBS). J Can Assoc Gastroenterol. 2019;2(1):6-29. doi:10.1093/jcag/gwy071
  8. Moayyedi P, Andrews CN, MacQueen G, et al. Canadian Association of Gastroenterology Clinical Practice Guideline for the Management of Irritable Bowel Syndrome (IBS). J Can Assoc Gastroenterol. 2019;2(1):6-29. doi:10.1093/jcag/gwy071
  9. Johannesson E, Ringström G, Abrahamsson H, Sadik R. Intervention to increase physical activity in irritable bowel syndrome shows long-term positive effects. World J Gastroenterol. 2015;21(2):600-608. doi:10.3748/wjg.v21.i2.600
  10. Mark Beattie, « Bacterial overgrowth », Oxford Medicine Online,‎ septembre 2018 (DOI 10.1093/med/9780198759928.003.0040, lire en ligne [archive], consulté le 10 janvier 2019)
  11. https://www.youtube.com/watch?v=Gjsga5DlOZY
  12. Ardesia M, Villanacci V, Fries W. The agedgut in inflammatoryboweldiseases. Minerva GastroenterolDietol. 2015 Dec;61(4) 235-247. PMID: 26603728.,
  13. Gabbard, SL ,Lacy, BE , Levine, GM , Crowell, MD . The Impact of alcoholconsumption and cholecystectomy on small intestinal bacterialovergrowth. Dig Dis Sci. 2013.
  14. Ghoshal UC, Shukla R, Ghoshal J. Small intestinal bacterialovergrowth and irritable bowelsyndrome: a bridge betweenfunctionalorganicdichotomy. Gut liver. 2017;11(2):196-208.
  15. Andrea Michielan, Renata D’Incà, 2015, Review Article : Intestinal Permeability in Inflammatory Bowel Disease : Pathogenesis, Clinical Evaluation, and Therapy of LeakyGut,Volume 2015, Article ID 628157, 10 p., https://doi.org/10.1155/2015/628157
  16. PyndtJørgensen, B., Winther, G., Kihl, P., Nielsen, D., Wegener, G., Hansen, A., &Sørensen, D. (2015). Dietarymagnesiumdeficiency affects gutmicrobiota and anxiety-like behaviour in C57BL/6N mice. Acta Neuropsychiatrica, 27(5), 307-311. doi:10.1017/neu.2015.10
  17. Khalighi AR, Khalighi MR, Behdani R, et al. Evaluating the efficacy of probiotic on treatment in patients withsmall intestinal bacterial overgrowth (SIBO)--a pilot study. Indian J Med Res. 2014;140(5):604–608.
  18. Devinder Dhingra, Mona Michael, Hradesh Rajput et R. T. Patil, « Dietary fibre in foods: a review », Journal of Food Science and Technology, vol. 49, no 3,‎ 12 avril 2011, p. 255–266 (ISSN 0022-1155 et 0975-8402, DOI 10.1007/s13197-011-0365-5, lire en ligne [archive], consulté le 10 janvier 2019)
  19. Yu ZC, Cen YX, Wu BH, et al. Berberine prevents stress-induced gut inflammation and visceral hypersensitivity and reduces intestinal motility in rats. World J Gastroenterol. 2019;25(29):3956-3971. doi:10.3748/wjg.v25.i29.3956
  20. Clark AK, Haas KN, Sivamani RK. Edible Plants and Their Influence on the Gut Microbiome and Acne. Int J Mol Sci. 2017;18(5):1070. Published 2017 May 17. doi:10.3390/ijms18051070
  21. Chang, C., Lin, C., Lu, C. et al. Ganoderma lucidum reduces obesity in mice by modulating the composition of the gutmicrobiota. Nat Commun 6, 7489
  22. Söderlund S, Granath F, Broström O, et al. Inflammatory bowel disease confers a lower risk of colorectal cancer to females than to males. Gastroenterology. 2010;138(5):1697-1703. doi:10.1053/j.gastro.2010.02.007
  23. Parian A, Limketkai BN. Dietary Supplement Therapies for Inflammatory Bowel Disease: Crohn's Disease and Ulcerative Colitis. Curr Pharm Des. 2016;22(2):180-188. doi:10.2174/1381612822666151112145033
  24. Li XX, Liu Y, Luo J, Huang ZD, Zhang C, Fu Y. Vitamin D deficiency associated with Crohn's disease and ulcerative colitis: a meta-analysis of 55 observational studies. J Transl Med. 2019;17(1):323. Published 2019 Sep 23. doi:10.1186/s12967-019-2070-5
  25. Ghishan FK, Kiela PR. Vitamins and Minerals in Inflammatory Bowel Disease. Gastroenterol Clin North Am. 2017;46(4):797-808. doi:10.1016/j.gtc.2017.08.011
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