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Irritable bowel syndrome is a common gastrointestinal disorder present in 10% of the population and especially in women. There are four categories of patients: those with a predominance of constipation, diarrhea, mixed (alternating constipation and diarrhea) or post-infectious (occurring after severe infectious diarrhea). This syndrome has long been trivialized and the psychological state of the patient has been questioned. ln this Master's thesis, the physiopathology will be approached as well as the existing pharmacological treatments. ln the physiopathology part, some points will be developed such as modification of the microbiota, visceral hypersensitivity or the brain-gut axis. The drugs can then act on the serotonergic, cholinergic pathways, smooth muscle or bile acid. For most treatments, the efficacy remains to be proved for this pathology. This multifactorial functional disorder, while not altering life expectancy, has a strong impact on quality of life. Le syndrome du côlon irritable est un trouble gastro-intestinal fréquent présent chez 10% de la population et particulièrement chez les femmes. Il existe quatre catégories de patients : ceux avec une prédominance de constipation, diarrhéique, mixte (alternance constipation et diarrhées) ou post-infectieux (survenant après une diarrhée infectieuse sévère). Ce syndrome a longtemps été banalisé et l'état psychologique du patient a été remis en question. Dans ce mémoire, la physiopathologie sera approchée ainsi que les traitements pharmacologiques existants. Dans la partie physiopathologie, certains aspects seront développés tels que la modification du microbiote, l'hypersensibilité viscérale ou encore l'axe intestin-cerveau. Les médicaments peuvent alors agir sur la voie sérotoninergique, cholinergique, sur les muscles lisses ou encore sur les acides biliaires. Pour la plupart des traitements, l'efficacité reste à prouver pour cette pathologie. Ce trouble fonctionnel multifactoriel, bien qu'il ne modifie pas l'espérance de vie, agit fortement au niveau de la qualité de vie.

Irritable Bowel Syndrome --- Irritable Bowel Syndrome

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Background: Irritable bowel syndrome (IBS) is a chronic functional disorder. lts prevalence reaches 10 to 15 % in the world. For some years now, research interest has been growing as for the possible implication of certain type of food in the typical symptoms of IBS. The so-called FODMAP approach, established by a group from the Monash University (Australia), represents one of the emerging treatments of the IBS. Meanwhile, numerous research projects showing the efficacy of this diet have been published. However - to our knowledge - no randomized study has ever been performed on that topic in Belgium. Objectives: The aim of the present study is to evaluate the effects of a low-FODMAP diet on the symptoms and the quality of life of patients suffering from IBS. Secondary goals consist in the evaluation of the impacts of that diet on the symptoms of anxiety and the psychosocial well-being of the patients, as well as the feasibility of a low-FODMAP diet and the level of facility when following it. Furthermore, we investigated the possible correlation between a Hydrogen Breath Test and the response to the diet. Methods: We initiated a simple-blind, randomized controlled trial against placebo (Sham: « standard IBS » diet). In total, twelve patients suffering from IBS were included in the study. After an observation period of 13 days, patients were randomized before undergoing either a low­ FODMAP diet, or the Sham diet. Patients had to fill in questionnaires specifically related to IBS (daily form, IBS-SSS, IBS-QOL, VSI, IBS-GAI) at every step of the study. Results: A total of twelve adult patients with IBS were included in the study. Eleven of them were randomized (FODMAP 5; Sham 6).20% of patients are defined as responders in the Sham group, whereas this number was 50% in the low-FODMAP group. Conclusion: The main limits of the present study are the low number of patients included to date (n = 12) and the methodological difficulties generally encountered when performing a dietetics clinical study. Continuing to recruit patients for the study will enable us to increase the statistical power of our investigatory results, to confirm the advantages of a FODMAP diet in IBS for a Belgian population. Contexte : Le syndrome de l'intestin irritable (SII) est un trouble fonctionnel chronique de l'intestin. Sa prévalence mondiale s'élève à 10 à 15 %. Depuis quelques années, l'implication de certains aliments dans les symptômes du SII est de plus en plus étudiée. L'approche FODMAP, mise en place par une équipe de l'université de Monash en Australie, représente l'un des traitements émergeants du syndrome de l'intestin irritable. De nombreuses études montrant l'efficacité de ce régime ont été publiées mais à notre connaissance, aucune étude randomisée contrôlée n'a été menée en Belgique. Objectifs: L'objectif du travail est l'évaluation de l'effet d'un régime pauvre en FODMAP sur les symptômes et la qualité de vie des patients souffrant du SIL Les objectifs secondaires sont d'évaluer l'effet du régime sur l'anxiété et les fonctions psychosociales, la faisabilité et la facilité à suivre un régime pauvre en FODMAP et la corrélation entre un test respiratoire à l'hydrogène (fructose) et la réponse au régime. Matériel et méthodes :Pour ce faire, nous avons entamé une étude randomisée en simple aveugle, contrôlée par placebo (Sham : régime « standard SII »). Des patients adultes souffrant du SII ont été inclus, selon des critères d'exclusion et d'inclusion précis. Après une période d'observation de 13 jours, les patients ont été randomisés pour suivre soit le régime pauvre en FODMAP, soit le régime « standard SII ». Des questionnaires spécifiques au SII (formulaire journalier, IBS­ SSS, IBS-QOL, VSI, IBS-GAI) ont été remplis par les patients à chaque étape de l'étude. Résultats : Un total de douze patients adultes souffrant du SII a été inclus dans l'étude. Onze d'entre eux ont été randomisés (FODMAP 5 ; Sham 6).Dans le groupe Sham, 20% des patients ont été définis comme répondeurs, tandis que ce chiffre était de 50% dans le groupe FODMAP Conclusion :L'étude présente certaines limites, principalement la faible taille de l'échantillon (n = 12) et les difficultés méthodologiques de mise en place d'une étude clinique diététique. Continuer l'inclusion de patients dans l'étude nous permettra d'augmenter la puissance statistique du travail afin de confirmer les avantages pour une population belge d'un régime FODMAP dans le SIL

Irritable Bowel Syndrome --- Diet, Carbohydrate-Restricted

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Conquering Irritable Bowel Syndrome aims to help empower people who suffer with IBS as well as their families. What is IBS? Why do some people get the disease? What can be done about it now that truly works? Take control and read on.

Irritable Bowel Syndrome --- Colonic Diseases, Functional --- Digestive System Diseases

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Chronic or repeated stress, particularly psychosocial stress, is an acknowledged risk factor for numerous affective and somatic disorders in modern societies. Thus, there is substantial evidence showing that chronic stress can increase the likelihood of major depressive disorder and anxiety disorders, as well as cardiovascular diseases, irritable bowel syndrome and pain syndromes, to name but a few, in vulnerable individuals. Although a number of pharmacological agents are available to treat such stress-related disorders, many patients do not respond to them, and those who do often report a number of side effects. Therefore, a major emphasis in modern basic research is to uncover the underlying aetiology of these disorders, and to develop novel efficacious treatment strategies. This has led to a resurgence in developing, and using, appropriate animal models to study a wide variety of stress-related disorders. Thus, the aim of this research topic “Using stress-based animal models to understand the mechanisms underlying psychiatric and somatic disorders” was to bring together novel research articles and comprehensive review articles from prominent stress researchers. In addition to describing the insights such models have provided relating to the aetiology of psychiatric and somatic disorders, these articles also encompass mechanisms that are believed to underlie stress resilience and stress-protection. Finally, given the current prominence on the role of the brain-gut axis in health and disease, the research topic covers the emerging evidence showing how the gut, particularly the microbiota, influences affective behaviour and physiology.

stress --- Glucocorticoids --- Irritable Bowel Syndrome --- behaviour --- microbiome --- Animal Models --- Prefrontal Cortex --- stress --- Glucocorticoids --- Irritable Bowel Syndrome --- behaviour --- microbiome --- Animal Models --- Prefrontal Cortex

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Chronic or repeated stress, particularly psychosocial stress, is an acknowledged risk factor for numerous affective and somatic disorders in modern societies. Thus, there is substantial evidence showing that chronic stress can increase the likelihood of major depressive disorder and anxiety disorders, as well as cardiovascular diseases, irritable bowel syndrome and pain syndromes, to name but a few, in vulnerable individuals. Although a number of pharmacological agents are available to treat such stress-related disorders, many patients do not respond to them, and those who do often report a number of side effects. Therefore, a major emphasis in modern basic research is to uncover the underlying aetiology of these disorders, and to develop novel efficacious treatment strategies. This has led to a resurgence in developing, and using, appropriate animal models to study a wide variety of stress-related disorders. Thus, the aim of this research topic “Using stress-based animal models to understand the mechanisms underlying psychiatric and somatic disorders” was to bring together novel research articles and comprehensive review articles from prominent stress researchers. In addition to describing the insights such models have provided relating to the aetiology of psychiatric and somatic disorders, these articles also encompass mechanisms that are believed to underlie stress resilience and stress-protection. Finally, given the current prominence on the role of the brain-gut axis in health and disease, the research topic covers the emerging evidence showing how the gut, particularly the microbiota, influences affective behaviour and physiology.

stress --- Glucocorticoids --- Irritable Bowel Syndrome --- behaviour --- microbiome --- Animal Models --- Prefrontal Cortex