It has five hundred million neurons and it is referred to as “the second brain”: we are talking about the intestine, an organ essential not only for digestion, but also for the immune defense, the production of hormones, and for various other physiological functions. Influenced in its activity by nutrition and individual psychophysical well-being, the intestine has a length that varies between seven and ten meters, is made up of two parts: the small intestine and the large intestine – and processes about thirty tons of food and fifty thousand liters of liquids during the average human life.
One of the most common intestinal conditions is irritable bowel disease. “About two out of ten people suffer from it and, after the flu, it is the second reason for absence from work. This condition has an important impact on the quality of life of patients – especially women – who suffer from it”, explains Professor Silvio Danese, Head of the Center for Chronic Inflammatory Bowel Disease at Humanitas and professor at Humanitas University in his interview with Elisir (Rai Tre channel).
Digestion starts from the mouth
We tend to forget about it, but chewing properly is very important: “both because we help the digestive system and because the enzymes that start the digestive process are already present in the saliva. After swallowing, the food goes into the esophagus and then to the stomach, where it encounters acids that further aid digestion. Then the food proceeds into duodenum, which is the first part of the intestine, where the enzymes of the pancreas are found; and eventually the actual absorption begins. The small intestine, in fact, has the function of absorbing all the nutrients: a process that is completed in the colon and which is followed by the elimination of waste “, the professor explains.
Irritable colon: what are the symptoms?
“The symptoms are very variable. The disorder can manifest itself with diarrhea or, conversely, with constipation; other common symptoms are swelling and the presence of pain in the abdomen that the patient is unable to locate precisely. The causes are also very varied, ranging from biological factors, such as an alteration of the motility of the intestine, to emotional and psycho-cognitive ones: irritable colon, not surprisingly, mainly affects individuals of working age, and patients often associate the pain to a stressful event that in some way triggered or exacerbated the symptoms, ” continues the doctor.
“There is no diagnostic test for irritable bowel syndrome. Often the diagnosis is one of exclusion and is largely based on the clinical history of the patient, who may have been suffering from this disease for some time. The gastroenterologist has to check that there are no alterations in the general examinations or stool tests and exclude intestinal infections. If the patient exhibits symptoms that might indicate a more alarming situation, we proceed with more invasive tests, but it should be emphasized that, in itself, the irritable bowel syndrome is a benign condition and has no risk of evolving into more serious diseases.”
What are the treatment options?
“Irritable bowel syndrome being such a multifaceted pathology, we must always identify the main issue for each individual patient. As mentioned previously, stress and external factors can influence intestinal regularity. Moreover, allergies can also represent a risk factor: some foods, over time, can cause intolerances. This is why it is useful to maintain a food diary, to try to identify the foods that cause discomfort.”
“Constipation can be alleviated by the incorporation of fiber or changes in nutrition and lifestyle. For patients, for whom these techniques are not helpful, we can prescribe drugs. We practice the same approach with patients presenting symptoms such as diarrhea, pain or meteorism: these are all conditions that can be partially managed through a change in lifestyle and/or with a pharmaceutical treatment. In general, in order to keep the bowel healthy, everyone should adopt a healthful diet and lifestyle, practice physical activity, counteract stress, and use drugs only for targeted purposes and always under medical advice and supervision, ” Professor Danese concludes.
