Our intestine is about seven meters long and its last stretch is the colon. Professor Silvio Danese, Head of the Centre for Chronic Inflammatory Diseases of the Intestine, a guest in the studio at Tutta Salute on Rai3, spoke about irritable colon – and more generally about irritable bowel syndrome.

Irritable bowel syndrome is an increasingly frequent condition, as Professor Danese explains: “When we talk about the syndrome in medicine, we are referring to many symptoms or signs that are common to many diseases and indeed it is the case of irritable bowel syndrome that presents signs and symptoms that can be confused with other diseases.


What are the symptoms?

“The symptoms are very varied and one of the most frequent is intestinal irregularity, patients report alternating diarrhea and constipation, and very often you can associate pain of the belly and in some cases there is swelling (meteorism).

There may also be extra intestinal symptoms: headache, irritability, concentration disorders and general malaise.

The symptoms have a chronic swinging trend, so there may be periods of remission associated with periods of exacerbation. Patients often complain of an increase in symptoms during periods of high stress.

One may say that irritable bowel is the second cause for individuals being absent from work, after the common cold”.


What are the causes?

“We do not know many of the causes, but the alteration of motility certainly plays a role: once this disease was called spastic colitis, because there is an alteration in the function of the intestine. Then there is an alteration of the microbiota, that is of the intestinal flora – not only of the bacteria, but everything that composes it”.


How is Irritable Bowel Syndrome treated?

“At the moment, thanks to modern medicine, we are able to control the symptoms of this syndrome, but the cure is still a dream. A gastroenterologist should act as a tailor and try to cut the dress in relation to the patient’s symptoms, precisely because the symptoms are very varied. If the patient has a predominantly diarrheal symptomatology, he will need – for example – drugs that reduce intestinal motility; if the intestine is a little lazier, medicines that help motility will be necessary. The intake of these drugs must be individualized in relation to the symptoms of the patient,” says the professor.


The role of nutrition

“Food is very important, as there are foods that are not properly digested (FOD MAP), that retain water and create swelling and abdominal tension, which are often the cause of patients’ symptoms,” says Professor Danese.

We talk about FOD MAP and specifically those foods that it would be better to avoid for a certain period and then gradually reintroduce, little by little. F stands for fermentable, such as Oligosaccharides (sugars present in cereals that contain gluten and legumes), Disaccharides (in milk and milk derivatives), Monosaccharaides (simple sugars contained in fruit, fruit juices and honey) and Polyalcohols (in mushrooms, cauliflowers and artificial sweeteners).