Since the publication of the book The Second Brain, in 1998, by American physician Michael Gershon, evidence has multiplied on a possible link between the brain and the intestine.
A study published in late 2021 in the scientific journal Nature Genetics analyzed genomic data from 53,400 people with irritable bowel syndrome (IBS) and 433,200 people without a diagnosis, and found six genes that increase susceptibility to IBS disease. . Of these, four are also associated with mood and anxiety disorders.
But what is this syndrome? The definition of IBS, according to Joaquim Prado Pinto de Moraes Filho, director of the Brazilian Federation of Gastroenterology, is a “functional digestive” disease. “There are no anatomical or morphological changes. It’s the function that’s not right. The brain communicates with the gut all the time, very harmoniously. But, under certain circumstances, that connection fails.”
Some of the symptoms most associated with IBS include: abdominal discomfort and pain; bloated stomach; frequent colic; exaggerated gas production; alternating stool frequency (periods of diarrhea followed by constipation); change in stool; and feeling of incomplete evacuation.
To confirm the diagnosis, patients must report symptoms for at least 12 consecutive weeks. “Sometimes the person eats something different, or is in a more stressful week, and the bowel is deregulated, but then it goes back to normal. So it’s not an irritable bowel,” says Carlos Walter Sobrado , full member and past president of the Brazilian Society of Coloproctology.
“It is also important that the doctor, in addition to excluding other bowel diseases, also excludes lactose and gluten intolerance. Sometimes the patient comes to the office, mentions the foods that cause the most symptoms and, when ordering the tests, we identify the intolerance,” he points out.
“If there is a structural change, it could be diverticular disease, intestinal neoplasia or tumor, rectocolitis or Crohn’s disease. These diseases must be ruled out to say that it is the SII”, he reinforces.
Although there is no cure, the disease can be controlled with medication (which will work in the most acute symptoms) and with changes in diet, the inclusion of physical exercises and improved control stress.
It is essential to avoid fatty foods such as fried foods, as well as coffee, chocolate and alcoholic beverages, especially since these foods increase gas production. In addition to analgesics, the use of natural fibers may be indicated, which moisturize the feces and help regulate the intestines; and probiotics like kefir.
“It is essential to have a multidisciplinary follow-up of the patient with IBS. Despite the directives and the drugs, the patient also benefits from psychological and nutritional support”, explains Sobrado. (Einstein Agency)