Apart from fairly rare genetic determinisms, eating habits and lifestyle can both contribute to irritable bowel syndrome and be its lifeline if we take the trouble to correct them.
Many suspicious food ingredients
The problem is as much about what we eat as how we eat it – too quickly, without conscience, at any time… Food preparations include an astronomical amount of ingredients whose health implications have not been assessed. However, studies have highlighted the deleterious role ofemulsifiers commonly used in human food, such as carboxyméthylcellulose, suspected of disrupting, in the medium term, the composition of the intestinal microbiota and promoting inflammation. Likewise, the polysorbates, common texturing agentshave also been on the hot seat for years as they may contain harmful residues such asethylene oxide, and suspected of modifying intestinal absorption. And the more we investigate, the longer the list grows: other emulsifiers, sweeteners, maltodextrin, carrageenans, colorings, preservatives… So many ingredients that affect the intestinal flora, the integrity of the mucosa and probably the enteric nervous system.
A bacterium that protects against the harmful effects of emulsifiers?
If you want to mix oil and water, you need a emulsifier. It’s what the food industry makes to improve the texture and extend the shelf life of food. But emulsifiers, very generously used in ultra-processed products, have known adverse effects on the gut. They degrade the mucus layer, which promotes excessive permeability, disruption of the microbiota and inflammatory phenomena. Scientists may have found a solution: the bacterium Akkermansia muciniphila*, naturally present in the intestine. Mice who were administered emulsifiers but also a dose of Akkermansia did not show the effects usually observed: inflammation, alterations in metabolism, increase in blood sugar… The greater the presence of the bacterium, the more the individual would be protected from the harmful effects of emulsifiers. But isn’t it best to limit our consumption of emulsifiers?
*N. Daniel, AT Gewirtz and B. Chassaing, in BMJ Journals, January 2023.
Some food staples to look out for too
But these artificial ingredients, which are found mainly in “elaborate” commercial preparations, are not the only ones to create problems. Staple foods themselves can also, in many cases, upset the digestive system.. We all eat, on occasion, fruits, vegetables, meats, fish, herbs, dairy products and of course bakery products, some of whose compounds interfere with our digestion (and then our metabolism) because we are not not adequately “equipped” (with digestive enzymes, for example) to digest them properly.
Without causing such drastic manifestations as well-known allergens such as peanuts, shellfish, eggs and others, many foods can cause a lower level of intolerance, and nevertheless active and deleterious. They are likely, over time, to act as antigens and may stimulate the immune system inappropriately, possibly leading to a chronic inflammatory conditionor even an autoimmune pathology.
Fermented Foods Soften Digestion
THE lacto-fermented foods (for example sauerkraut, kefir, sourdough bread, etc.) are subject to “predigestion”, especially of proteins, leading to an enrichment in vitamins and antioxidantsas well as the development of a specific microflora.
Result: digestion is easier and allows the intestine to regenerate and better absorb nutrients.
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Avoid eating at night and between meals
The ease with which we have access to a plethora of sweet and savory treats between meals may well be an important factor in intestinal dysbiosis. Indeed, our digestive system needs each stage of digestion to be completed before a new cycle is imposed on it. Likewise, the nocturnal “fasting” period is essential for the digestive tractwhich must be able to be expurgated on a regular basis.
Eating at too short intervals is one of the main causes of another digestive system disorder, the Sibo (for small intestinal bacterial overgrowth) or bowel bacterial overgrowth (PBG). The latter could have repercussions downstream of the digestive tract, and is not easily distinguished from other digestive diseases such as celiac disease, inflammatory colitis or irritable bowel. Breathing tests (with hydrogen, in first intention) are the reference examination for the diagnosis of PBG. According to a 2020 meta-analysis, Sibo affects 31% of people with irritable bowel syndrome, but according to other sources, this proportion could rise to 75%!
The essential “migrating motor complex”
The small intestine, responsible for the absorption of nutrients, is not intended to be colonized by an important bacterial flora (small bacterial proliferation or PBG). To protect itself from this, it proceeds at regular intervals (approximately 90 minutes) to a mechanical “hunting”, called a migrant motor complex. Eating too often weakens this healing waveopening the way to the proliferation of bacteria such as Bacteroides, which promote malabsorption.
Pamper our immune cells
The damage we inflict on the microbiota, whether by nbone eating habits, medicationbut also other factors such as our ecosystem mental and psychic or even the stress that we undergo, extend also to the sphere of theimmunity : the intestinal lumen is home to the largest population of immune cells. In addition to their interdependence with the richness of the intestinal flora, these are continually exposed to toxins, antigens and other pathogens carried by the food bolus. These cells lead a perpetual struggle to quickly neutralize these agents, which implies the existence of a certain level of “physiological” inflammation.
But at the same time, the entire intestinal ecosystem must avoid sliding towards a chronic inflammationlikely to cause autoimmune damage (Crohn’s disease, ulcerative colitis), or to induce functional alterations, such as weakening of peristalsis For example. This veritable balancing act is possible in particular with the help of a healthy microbiotawhich seems to be the cornerstone of all the subtle interactions that take place with immune cells, the intestinal neural network and the central nervous system.
Probiotics to the rescue
Most probiotics contribute to intestinal comfort. However, some strains target IBS more effectively, in particular bifidobacteria:
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- Bifidobacterium infantis 35624 reduces pain and bloating and tends to normalize transit after thirty days of intake, significantly improving quality of life.
- Bifidobacterium lactis DN-173010incorporated into certain yoghurts, accelerates and facilitates transit in patients with constipation.
- Bacillus coagulans LBSC is another commercial line that also relieves pain, nausea and vomiting, and diarrhea as well as constipation.
Many other microorganisms, such as L. plantarum LP01 and L. acidophilus LA02 or Saccharomyces boulardiihave also confirmed their contribution and are also marketed.
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A second brain very sensitive to stress
The enteric nervous system, often called “second brain” and with some 200 million neurons, autonomously controls the entire digestive process: vascularization, motility, gastric fluid secretions, among others. It is therefore inevitable that any dysfunction of this neural network will have an impact on gastrointestinal functioning. Many recent works indicate that homeostasis within the digestive ecosystem depends on close interrelationships between the enteric and central nervous systems, the microbiome and the intestinal immune ecosystem. Interference in these interactions can initiate a breakdown in homeostasiscapable of causing irritable bowel syndrome.
Several recent studies on mice have demonstrated the direct implication stress and negative emotions in the initiation of symptoms suggestive of irritable bowel syndrome. Stress is suspected of modifying the composition of the microbiota, and in very young subjects, including in the perinatal period, ofalter the development of the enteric nervous system in a supposedly irreversible way (according to current knowledge). With consequences on the integrity of the intestinal epithelium, motility and digestive secretions, but also, later, on the ability to respond to stress. Damage to the enteric nervous system ranges from simple disturbances in its biochemistry to complete loss of glial cells (neural support cells) in certain sections of the intestine.
These alterations would, moreover, preferentially affect women.for reasons still unclear, but probably involving certain hormones like FSH and LH (which trigger ovulation).
The enteric nervous system may also be subject to neuropathiesin the same way as the central nervous system, resulting in particular from infection, toxic agents (including antibiotics taken too early in life) or other diseases such as diabetes or neurodegenerative diseases.