Scientists are starting to elucidate the roots of gastrointestinal symptoms that appear after a meal in people with irritable bowel syndrome. Current research highlights the immune drivers of gut pain, which could offer clues on how to treat IBS.
"An explanation for repeated bouts of abdominal pain, bloating, diarrhea, or constipation may lie in the small intestine
IBS is the most frequently diagnosed gastrointestinal disorder. Patients with this vexing condition often report abdominal pain, discomfort, fullness, and bloating without an apparent explanation in the medical work-up.
IBS has long been called a functional disorder, meaning it is a condition with no identifiable cause and no visible signs of damage in the digestive tract.
However, the Rome Foundation recently renamed IBS as a disorder of gut-brain interaction after recognizing the interplay between central (e.g., psychological conditions such as stress and anxiety coinciding) and peripheral digestive alterations (e.g., an increased pain perception in the bowel) in most patients with IBS1.
Beyond the involvement of colonic dysbiosis in IBS, the fact that symptoms appear mainly within one hour of meal ingestion suggests the small intestine is also involved in its onset and development2.
The small intestine has been overlooked mainly due to technical difficulties in accessing and studying it. Its main functions are the digestion of food and the absorption of nutrients into the bloodstream. It is worth noting that about 70% of body immune cells are found in the small intestine in structures collectively called gut-associated lymphoid tissue (GALT). The small intestine also has its own microbiota but is found at a lower diversity and density compared to the colon3,4."
Written by
Meleber
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So is it always that IBS symptoms arrive within 1 hour of a meal?
Mine don't. I am usually fine and feel great for hours after eating a meal. I mean, I could eat anything and feel fine.
IF I am going to get any problems after eating it will happen usually about 4 hours later, last for an hour, then die down. Then I'll usually be ok again until the next morning. when all will either be well...or it won't.
Those problems do not happen all the time or every day. I go through phases of that discomfort hours after eating. Plus, it's not dependent on what I eat. It'll either happen or it won't.
"So is it always that IBS symptoms arrive within 1 hour of a meal?"
I don't know but it happened to me for a long period, years ago. And after some hours of lying on the couch it felt somewhat better. The last gastroenterologists I spoke with (September this year) told me that the motility of my small intestine and colon isn't working properly, working too slow. The propulsion (neuromuscular problem🤔) is too weak to overcome the gravity, hence the problem with accumulation of fecal mass in my cecum, ascending colon. That is why I'm now on a trial of the drug prucalopride for 4 weeks.
Hi Meleber, I developed IBS-D about 7 years ago following a bout of gastroenteritis. I have had many investigations with the only clinical finding being extensive diverticulosis. My consultant said this should not affect me unless the diverticula become infected, when it is called diverticulitis.
However when I completed the FODMAP elimination diet, I realised that excluding fructose and the polyols from my diet resolved the debilitating diarrhoea, which tended to occurr 4-7 hours after ingestion. The only thing I have 1 hour after eating is noisy gurgling in my stomach.
Even though I don't have the diarrhoea anymore, I still have the others IBS symptoms which goes to show the cause of IBS is multifactorial as mentioned in the excellent publication you sent us.
If my stomach reacted to a meal as suggested, I think my IBS would be fairly easy to handle. Control what and when I eat, and expect a reaction. But it doesn't work like that for me. Usually nothing happens, sometimes some queasiness. Its the unexpected onset of stomach cramps and 5/10 minute warning of complete bowel evacuation which frightens me, at total random times. During a walk, reading a book, often completely relaxed and unprepared.
related to immune response… magnesium is a big factor for immune system. You also lose it through stress and bowels movements a lot of what this expect is making it worse
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