Food in functional gastro-intestinal disorders: friend or foe?
Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder. With an approximative global prevalence of 11.2%, IBS is a commonly diagnosed disorder that can have a substantial impact on patients’ quality of life as well as a huge economic impact on society (Oka, 2020). The pathogenesis of IBS is multifactorial, and IBS can be associated with altered intestinal motility, visceral hypersensitivity, altered brain–gut interactions, dysbiosis, increased intestinal permeability, and/or mucosal immune activation (Ford, 2018). Although there is not a specific food that triggers the condition, people suffering from this disorder report that certain foods, or their combination, can promote or aggravate symptoms.
This month, the issue of the Global Fruit and Veg Newsletter sheds light on this syndrome with three recent articles. It covers the mechanistic approach of how diet, and more particularly FODMAPs, can dysregulate the colonic mucus barrier as well as dietary advice for irritable bowel syndrome, with a focus on a key nutrient -dietary fiber- that provides functional and physiological benefits.
The first article from a French group of researchers explores the mechanistic implication of an increased intake of dietary fermentable carbohydrates in mucus barrier particularities. The study shows that excessive intake of fermentable carbohydrates can cause colonic mucus barrier dysregulation in mice, by a process that involves glycating agents and increases mucosal mast cell counts.
The second article is an expert review of the American Gastroenterological Association (AGA) providing advice statements, mainly to gastroenterologists, with regards to the role of diet in IBS treatment.
The third article focuses on the role of dietary fibre intake in healthy children but also in case of functional digestive disorders such as IBS and constipation. This review highlights the importance of the quality of fiber consumed and emphasizes that a healthy diet should contain both fermentable and bulking fiber.
Pauline Jouët is a medical doctor and has a PhD in epithelial biology and pathology (Université Paris VII). She has worked as a researcher in Pr SARNA’s laboratory, Wisconsin, USA, 1992-1994). She is Professeur associée at the Collège de Médecine des Hôpitaux de Paris, works full time at Avicenne Hospital (Bobigny, France) as a gastroenterologist, and at the INSERM U 987 unit (Dr Bouhassira, Boulogne-Billancourt). She currently is the President of the French Groupe of Neurogastroenterology (GFNG) and is part of the scientific committee of the french association for IBS patients (appssii.org).