Recent studies and books are beginning to pay more attention to our gut. Inflammatory bowel diseases, and less severe conditions associated with irritable bowel syndrome, have long plagued people. However, given the nature of these conditions, many of those people suffered with their pain and discomfort in silence, without receiving proper medical care.

Our current state of gut health

Now, however, we are beginning to study how these conditions of the gut are affecting people every day. We can start to understand the impact of these conditions by considering that:

• The CDC estimates that as many as 1.4 million people in the U.S. suffer from irritable bowel diseases
• The CDC also reports that irritable bowel diseases have an overall healthcare cost of $1.7 billion
• Ulcerative colitis, one of the more common irritable bowel diseases, affects as many as 700,000 people in the U.S.
• The Crohn’s & Colitis Foundation of America also estimates that another 700,000 people in the U.S. suffer from Crohn’s disease
• Certain studies cited by the National Institutes of Health estimate that irritable bowel syndrome may affect as many as 20% of the U.S. adult population

Understanding irritable bowel diseases

Irritable bowel disease (IBD) describes a number of chronic or recurring gastrointestinal conditions. Most often with this disease, the body’s own immune system will respond in an overactive, abnormal way to food and other materials in the intestines. Due to this, the immune system actually attacks the cells of the intestines, leading to chronic inflammation.

In Crohn’s disease, this inflammation generally affects the end of the small bowel and the beginning of the large bowel. With ulcerative colitis, the inflammation is limited to the colon, or large bowel.

Symptoms of both conditions include:

• Loose stool or diarrhea
• Cramps
• Abdominal pain
• Fever
• Extreme weight loss
• Fatigue

Because of their severe nature, most patients with these conditions require medication or even surgery to control symptoms.

Defining irritable bowel syndrome 

Though they both affect the gut, irritable bowel syndrome is not to be confused with irritable bowel disease. Instead of intestinal inflammation, irritable bowel syndrome (IBS) is characterized by changes in how the GI tract works, but not actual damage to that system. Irritable bowel syndrome, however, does share many of the same symptoms, including diarrhea and abdominal pain.

Unlike irritable bowel diseases, the causes of IBS are not as well understood. Instead of a single dysfunction in the body, irritable bowel syndrome may be caused by a combination of factors, including:

• Brain to gut signaling problems
• GI tract motor problems
• Hypersensitivity
• Mental health issues
• Small intestinal bacterial overgrowth
• Body chemicals, such as GI hormones
• Genetics
• Food sensitivities

Since there are such a wide range of possible causes, there are often overlaps between irritable bowel syndrome and other medical conditions. IBS has a high association with other conditions like chronic fatigue syndrome, chronic pelvic pain, TMJ disorder, chronic pain, depression, and anxiety.

Research about the gut

Now that we are beginning to truly grasp the extent of these health conditions, research is uncovering even more information about their causes, risk factors, and possible treatments.

Let’s look at some of the more recent research.

• Scientists begin to understand the microbial diversity in our guts: In a talk at the Gut Microbiota for Health World Summit, researcher Gary Wu presented his findings on the complex and interwoven communities of microbiota in our guts. These include bacteria, archaea, and fungi that all work together to keep our guts healthy. A better understanding of these environments might help us target new therapies for treating IBD and IBS.
• Large-scale study zeroes in on Crohn’s disease bacteria: Research published in Cell Host & Microbe surveyed nearly 2,000 samples from Crohn’s disease patients in an attempt to identify a shared pattern among them. What they found was a collection of microorganisms that flourished with disease activity. This can help doctors more easily diagnose Crohn’s disease by testing for these markers. It can also help researchers create a blueprint that could lead to future microbial therapies.
• Despite the hype, probiotics won’t prevent Crohn’s disease relapse: You may have seen the word “probiotics” on yogurts, fermented foods, or other health foods in the grocery store. Probiotics contain the beneficial bacteria that normally inhabit our guts. While probiotics still hold promise for relieving IBS symptoms, researchers have shown that probiotics unfortunately do not have any significantly beneficial effects for people with Crohn’s disease.
• Drugs, on the other hand, might: Researchers from St. George’s University of London recently found that Crohn’s disease surgery could be reduced by up to 60% in patients who received prolonged, thiopurine drug treatments. Since two-thirds to three-quarters of all Crohn’s disease patients require surgery to control symptoms, this could prove to be an incredibly effective therapy option.
• Genetic components found to IBS and IBD: Two research studies–one at the University of Cincinnati Academic Health Center and the other at Mayo Clinic–have found evidence of genetic clues to irritable bowel syndrome and irritable bowel disease. These findings could provide new targets for treatment.

New books give us a different view of our gut 

While the research into these conditions is crucially important, sometimes it is just as important to get a new perspective into the effects these conditions can have on the human body and our lives.

A recent book, The Man Who Couldn’t Eat by Jon Reiner, aimed to do just that.

Diagnosed with Crohn’s disease at a young age, Reiner recreates a harrowing portrait of the life he lives with the disease. The memoir is focused on one life-threatening moment when the disease threatens to overcome him. Through it all, he talks about how food is both comfort and identity, but also the thing that makes his body rebel. It’s an intensely personal look at the disease through one man’s eyes.

For a broader, and more humorous, view of the gut, read Mary Roach’s Gulp. Roach delves into the under-appreciated digestive system and explains what we do know about it and how we found out what we do know. Publisher’s Weekly wrote about it:

“It’s as gross as one might expect, but it’s also enthralling. … Roach’s approach is grounded in science, but the virtuosic author delights in giving readers a thrill.”

Do you suffer from irritable bowel disease or irritable bowel syndrome? What resources have helped you learn more about these gut conditions?

Image by Mary Margret via Flickr

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