Irritable Bowel Syndrome: Most Effective Supplements

Irritable Bowel Syndrome (IBS), also known as functional bowel disorder, is a common functional digestive disorder affecting around 15 to 20% of the global population, with increased prevalence among women. Characterized by recurrent abdominal pain associated with bowel movement disturbances (constipation, diarrhea, or alternating between both), IBS is distinguished by the absence of visible organic abnormalities in clinical and biological examinations.

Pathophysiology

The pathophysiology of IBS remains multifactorial and incompletely understood. It includes: 2Intestinal motility dysfunctionIn IBS, intestinal contractions are often irregular: either too fast in diarrheal forms or too slow in constipated forms. These motor anomalies disrupt transit, explaining the specific symptoms of each subtype. The colonic response to food is also altered, exacerbating postprandial pain.
52Visceral hypersensitivityIncreased sensitivity of intestinal nerves amplifies pain perception in IBS patients, even in the absence of inflammation. This hypersensitivity, due to hyperactivity of serotonergic and cholinergic receptors, is often linked to increased intestinal mucosal permeability.
52Microbiota imbalance and inflammationThe gut microbiota plays a key role in IBS. Qualitative and quantitative alterations (dysbiosis) can promote increased gas production and digestive disorders. These changes, often triggered by infections or antibiotics, also influence the immune system through the release of pro-inflammatory cytokines.
52Involvement of the central nervous systemThe gut-brain axis is central in IBS. Psychological stress disrupts neuro-gastroenteric signals, leading to increased serotonin secretion, a neurotransmitter involved in intestinal motility and mood regulation. A decrease in serotonin reuptake transporters has been observed in some patients, promoting motor and sensory disorders.

Trigger and risk factors

IBS often results from the interaction of multiple factors:
52Psychological stress and emotional history: Chronic stress disrupts the gut-brain axis and amplifies symptoms.
52Gastrointestinal infections: An acute gastroenteritis can durably disrupt intestinal motility and microbiota.
52Unbalanced diet: Meals high in fermentable sugars (FODMAPs) or fats worsen symptoms.
52Repeated use of antibiotics: This can lead to dysbiosis, weakening the intestinal barrier.

Clinical signs

The diagnostic criteria of IBS, as defined by Rome II and III classifications, allow identification of the disease in the absence of biological or structural abnormalities.
52Abdominal pain: Spasmodic or diffuse, they occur during the day and are often relieved by defecation or gas emission.
52Intestinal transit disorders: Constipation, diarrhea, or alternation of both, with sometimes mucousy stools.
52Bloating and flatulence: Felt as abdominal distension, often exacerbated after meals.
52Associated extra-digestive symptoms: Patients may also present with headaches, chronic pelvic pain, back pain, or even sleep disturbances and chronic fatigue. These manifestations indicate systemic involvement.

Diagnosis

The diagnosis of IBS is based on Rome III criteria and the exclusion of other digestive pathologies (chronic inflammatory bowel diseases, celiac disease, lactose intolerance). Complementary examinations include:
52Biological exams: To eliminate nutritional deficiencies or inflammatory syndromes.
52Colonoscopy: Indicated in case of alarm signals (weight loss, or recent symptoms in patients over 50 years old).

Management

The treatment of IBS is individualized and aims to improve symptoms while considering psychological and environmental factors.
52Dietary changes: Avoiding trigger foods, following a low FODMAP diet (fermentable) or adding fibers may be recommended.
52Medications: Antispasmodics for pain, laxatives for constipation, or antidiarrheals. Low-dose antidepressants may be prescribed for severe pain or associated anxiety.
52Behavioral therapies: Stress management techniques, such as cognitive-behavioral therapy or hypnotherapy, show promising results.
52Probiotics: Although evidence is limited, some probiotics may improve symptoms. The prognosis for IBS is generally favorable. Although it is a chronic condition, symptoms may fluctuate and respond to appropriate treatments. However, quality of life may be significantly impaired, necessitating psychological care in severe forms.