Inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) are the two most common gastrointestinal disorders worldwide. Both disorders place a great burden on patients, affecting their quality of life
Let's understand more about this chronic (IBD) and intermittent disease characterized by intestinal inflammation.
What we know about inflammatory bowel disease (IBD)
Inflammatory bowel diseases are chronic, multifactorial disorders, characterized by recurrent inflammation of the gastrointestinal tract. Environmental factors such as smoking, dietary habits, and lifestyle, associated with imbalances in immune responses, may contribute to BII. In addition, the qualitative and quantitative changes of intestinal microbiota in genetically susceptible people, it can favor the appearance of the disease.
Inflammatory bowel disease (IBD) has two phenotypes main clinics:
- Crohn's disease (BC)
- ulcerative colitis (WITH)
Crohn's disease is often transmural, meaning the inflammation can reach the full thickness of the intestinal wall and affect any part of the gastrointestinal tract intermittently, from the mouth to the anus, being more common in the region of the ileum (the final part of the small intestine), while UC involves mainly chronic inflammation of the mucosa confined to the colon, usually occurring in the rectum and continuously extending over part or all of the colon. Unlike BC, UC lesions are often limited to the epithelial lining.
What causes BII and what are the main symptoms?
Despite advances in BII research, etiology and pathophysiology are still complex and mostly unknown.
Clinically, it begins with a variety of symptoms, including abdominal discomfort, diarrhea, bloody stools, fever, fatigue and weight loss. There is attraction of neutrophils and macrophages that produce cytokines, proteolytic enzymes and radicals resulting in inflammation and ulceration.
Both Crohn's disease and ulcerative colitis they have the same clinical course , the differences being limited to the location and nature of the lesions. In addition to these commonly reported manifestations, patients with BIB often complain of extra-digestive complications that may involve dermatological, ocular, hepatobiliary and urological (kidney stones). Patients may also present with perianal complications that are uniquely limited to UC patients.
IBD and gut microbiota
Since the 19th century, when IBD was first described, it has been associated with a type of microbiota. BII consists of in mucosal inflammation and it is assumed that the gut microbiota plays an important role.
Proteobacteria, especially species Escherichia coli adherent-invasive, may be increased in patients with BII. With the increase of bacterial populations capable of triggering colitis, it is expected that other species of this microenvironment, with a protective profile, will be reduced, especially those that produce short chain fatty acids (SCFA), AS butyrate.
I am SCFA produced by intestinal bacteria from the fermentation of resistant starch or indigestible carbohydrates in our diet. These SCFAs play an important role in the immune system. Acetate, butyrate and propionate act as anti-inflammatories in the gut, helping to differentiate a very important class of cells in regulating the immune response, called Tregs. in the large intestine.
The frequent decrease in SCFA-producing bacteria in patients with IBD reinforces the importance of these microorganisms in maintaining intestinal homeostasis, modulating factors and producing important substances.
Treatment
Due to the complexity of BC and CU, the treatment is still difficult , immunobiologicals and immunosuppressants being used to block the production of cytokines, receptors or signaling molecules that mediate the action of inflammatory cells, and in some cases surgical intervention is needed.
Diet plays an important and certain role when it comes to influencing the composition of the gut microbiota in patients with IBD. Regarding the use of probiotics, the evidence is still inconclusive, in some cases there appears to be benefit, in others their use is discouraged. Remember that only a doctor/specialist can recommend a diet and probiotic therapy suitable for each case.
Test area microbiota: an ally in diagnosis and treatment
Examination of intestinal microbiota Max Profile , processed at the Lab. Teletest from Barcelona, can help health professionals develop strategies CUSTOM which promotes the modulation of microorganisms present in the intestine.
The test result will provide an overview of the most important bacterial populations. In addition, the test analyzes a variety of intestinal markers, enzymes, neurotransmitters, heavy metals And so on With this valuable information, the doctor and/or healthcare specialist will be able to be much more assertive in the diagnosis, as well as in the treatment of the patient with IBD, because the microbial profile of Crohn's disease and ulcerative colitis is already well characterized in the literature.
Other positive aspects of the Profil Max test is the sample processing technology, namely, RT-PCR technique (Molecular Biology-DNA, the most reliable technique at the present time ) and the result is accompanied by the personalized interpretation from the laboratory specialists.
Request the kit of harvesting Profil Max from any point in the country click here
Sources:
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GUAN, Q. A comprehensive review and update on the pathogenesis of inflammatory bowel disease, 2019. https://pubmed.ncbi.nlm.nih.gov/31886308/
LEE, M., et al. Inflammatory bowel disease and the microbiome: Searching the crime scene for clues, 2021. https://pubmed.ncbi.nlm.nih.gov/33253681/
NISHIDA, A., et al. Intestinal microbiota in the pathogenesis of inflammatory bowel disease, 2017. https://pubmed.ncbi.nlm.nih.gov/29285689/
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YOUNIS, N., et al. Inflammatory bowel disease: between genetics and microbiota, 2020.