Irritable bowel syndrome (Leaky out) - Leaky out

El síndrome de intestino sensible es un trastorno funcional digestivo de nuevo diagnóstico donde la inmunidad intestinal se ve alterada a causa de la permeabilidad en el ingreso de microorganismos y otros compuestos desde la barrera hasta el torrente sanguíneo. Es una afección que se caracteriza por sintomatología como cefaleas, cansancio, diarrea, hinchazón abdominal, intolerancia alimentaria, dificultad para bajar de peso y dolor articular sin una causa aparente. Debido a su cuadro clínico inespecífico, se le denomina como una patología de complejo diagnóstico.

The intestinal mucosa is an essential organic component with a surface area of 400 to 600 square meters, it is the major protective barrier of the human body with the exterior, second only to the skin. When this barrier is disturbed, elements such as nutrition and immunity will also be seriously affected. In comparison with the skin, which is composed of several layers, the intestinal mucosa has only one protective layer, the enterocytes. This layer is covered by a microprotectant (the microbiota) and underneath, a layer of immunoglobulin A, which provides protection and defense. Enterocytes are coupled together by intercellular junctions that act as selective proteins, which allow the passage of nutrients, but also prevent the entry of molecules larger than 50 Armstrong (molecular size), although there are also nutrients and minerals that can pass through the enterocytes. Human beta-defensin 2 (HBD-2) is a peptide produced by the mucosa of the inflamed colon, its creation depends on the activity of microorganisms and proinflammatory cytokines. Studies have found higher levels of HBD-2 in patients with IBS (Inflammatory Bowel Syndrome) compared to healthy patients.

In the walls of the digestive tract there are endocrine cells specialized in the secretion of hormones (mainly peptides) some of which have local action, while others produce their effects at the systemic level. The nervous system is controlled by the autonomic nervous system, a delegate in the involuntary actions of the body such as the beating of the heart and the dilation/contraction of blood vessels, many of its functions are regulated by local reflexes, integrated in the nerve plexuses of its own walls (the enteric nervous system).

Substances such as heavy metals, toxins, bacteria, viruses and food additives, disturb the enterocytes through the bloodstream, these undesirable substances can enter the systems (nervous, hormonal, immune, joint, etc.). This contamination increases the risk of developing metabolic diseases, allergies and asthma; thus it becomes important to protect and maintain the microbiota, an essential task for the proper absorption of these metals by the body.

The recovery of the integrity of the epithelial barrier can contribute to intestinal inflammation, enteric infections and celiac disease, some autoimmune diseases can be reduced when this barrier is in balance, likewise, the mechanisms of action involved in this benefit include the secretion of mucin, responsible for the gelatinous secretion of the body, the modulation of the phospholysis of proteins and the increase of transepithelial resistance.

Food intolerances are common in patients with IBS. Poorly absorbed carbohydrates can exert osmotic effects and lead to increased fermentation in the small intestine or colon, which exacerbates symptoms in these patients, as well as in people with biopolymers, with profound abnormalities in intestinal function and sensitivity. In the diet it is important to identify food ingredients that can potentially cause intestinal symptoms, such as fructose, lactose, fructans or sorbitol, studies recommend their selective elimination from the diet for partial and transitory relief.

One of the predominant symptoms in irritable bowel syndrome is abdominal pain or abdominal discomfort, which is associated with a change in stool solidity or stool frequency. In this syndrome, most of the symptoms are triggered or intensified by stress and in some patients by the ingestion of certain foods. Stress is one of the major causes that promote a permeable intestine, which translates into inflammation of the intestinal mucosa. This syndrome has been associated with states of anxiety, depression and somatoform disorders (disorders characterized by their psychological origin) in which physical signs are experienced due to an underlying medical condition.

The efficacy of probiotics in IBS proves that they are effective treatments. The transcendental role of melatonin in gastrointestinal physiology has also been demonstrated, including the regulation of motility, local anti-inflammatory and antinociceptive action, and melatonin treatments have shown a notorious improvement in abdominal pain and quality of life.

The first action to determine the treatment to follow is to identify the cause that originates the permeability. The patient must become aware of his condition, reducing stress and anxiety, allowing himself to perform physical activities that allow him to feel good, drink plenty of liquids (water) for purification, improve sleep cycles and create healthy habits, aspects that will be reflected in the immune system. All this, influenced in great part by the state of nutrition that the organism has.

Foods that help the health of the immune system: 

• Healthy probiotics such as yogurt, kefir, kombucha, kimchi, sauerkraut.

• Products rich in zinc:Dark chocolate, oysters, pumpkin seeds and peanuts.

• Foods with high levels of non-essential amino acids such as L-glutamine and L-arginine: Chicken, turkey, lean pork, spinach, nuts and fresh cheeses. They are also present in beef, seafood, almonds, lettuce, cucumber, onion, garlic, asparagus and lamb.

• Coffee, tea, alcoholic and carbonated beverages, medications that alter the intestinal mucosa, such as antibiotics, non-steroidal anti-inflammatory drugs and paracetamol, should be avoided.

• Xyloglucan: it is a polysaccharide, which prescribed and supervised by the treating physician, helps in the formation of membranes that protect the intestinal mucosa from aggressions by pathogens.