notes by dr Claudio Italiano
One of the most frequently asked questions addressed to the gastroenterology
clinic is the following: "How come I have a swollen belly, which turns and hurts
me and I immediately run to the bathroom, especially if I am stressed?".
I am
probably suffering from irritable bowel syndrome, which at the time was
described as irritable bowel syndrome, but it is more correct to define it in
the first way because the whole intestine is involved, therefore also the small
intestine.
First we point out that there are at least four varieties of irritable bowel
syndrome divided, in general, according to the predominant symptoms; the one
with the pains of the type "a colic", the variety without pain, with alternate
alve, ie between constipation and diarrhea and the variety with diarrhea and /
or with constipation predominant. So the first problem to be solved is to
recommend a correct feeding, in order to reduce the patient's hassles. Indeed,
these must be reassured, because in most cases, we are facing a female patient,
generally a very fine patient, subjected to considerable workloads, always
anxious, dutiful, a perfectionist, always attentive to the bad figures, which
are spent on work, which is always on time, that studies hard but does not make
much because of its introversion! This type of woman is the one who, if, for
example, must pass an exam, is already ill from the night before, with a swollen
stomach feeling, colic-like pain, like "if you had a spinning machine in your
tummy (!) "(Also see abdominal pain); this is what one hears the doctor
gastroenterologist say, who must also be a good psychologist in these cases. So
if the predominant type of symptoms is diarrhea and colic, a good antispastic,
to begin with, is the solution followed by the use of bacteria to colonize the
colon and, generally, this treatment will start to work; it can be, however,
that there is bacterial putrefaction, caused by stagnation of the feces, which
is possible in the forms with constipation to which the diarrheal episode or the
actual enteritis follows, and then antibiotic therapy will be performed in this
condition. The writer has already treated the topic and will refer you to this
page on the treatment of diarrheal syndromes.
Yes, we speak more correctly of diets, to indicate a suitable diet according
to the cases presented to the gastroenterologist. In the hospital, if we are
faced with the colic and constipation variety, the foods used for constipation
and a suitable water cure will be indicated. A proper diet provides for foods
that do not generate gas or cause contractions, since pain and colic are
determined by gaseous distension of the colon.
Foods with weak flatulogenic potential in forms with constipation and colic:
Second courses with side dishes: fish, provided you are not intolerant to fish
proteins, can be indicated, preferring blue fish, cooked without sauce, digested,
or steamed , or roasted, with a little oil, even of corn; or the meat, both red
and white; if there is constipation the vegetables are indicated, the simplest
one, the good and tender lettuce, the cucumbers which are very good and fresh,
the broccoletti, if not exaggerated, the peppers if you do not suffer from
acidity, never at night (!) ; if all this has been digested without problems,
neither colic, nor acidity, then we can indulge and try some good cauliflower,
perhaps boiled, or fresh tomatoes, boiled asparagus, boiled zucchini. The
aubergines (whoever writes is a ghiotto of the famous "mulincianedde chini", a
typical dish of Milazzo, come and taste them!), For example, are contraindicated
if you have constipation and colic. The most digestible fruit is melon (the
watermelon better not, because it stimulates too much diarrhea due to the
excessive load of water and salts to the colon, better than the Italian grape,
or rose grapes or black table grapes that is less sweet.
They go to the first courses: for those lean, not on a diet, pasta with fresh
tomatoes, some boiled potatoes, and bread, at first the white one and then try
the whole, with the bran, which we know is cellulose and therefore not
digestible and retains water.
Finally
mineral waters, which is why: water is important in the diet of the subject
suffering from irritable bowel syndrome with constipation, better if it is the
one with magnesium and sulphate, see the Tettuccio, the water of Tamerici, our
water Source of Venera, or the classic Uliveto, of Perugia, to drink always away
from meals, it is good also 1.5 liters / day; who writes it does sport and is
dedicated to gardening and to the garden of his house and drinks a lot, but if
the amount of water is excessive, if the water is not chlorinated (for example
that taken at the sources and / or premature of mountain) have an eye to the
charge of coliforms! It has happened to me to drink from the cane of the garden
in summer and that the water had an excessive charge of faecal bacteria, which
is possible with heat and the greenhouse effect of these years, when the pipes
remain without water and there is stagnation ! Then they were infectious
diarrhea and belly pains
In the forms of irritable bowel syndrome with diarrhea.
In general you start to try some rice, some tea, some potato puree, combining
them with lactic ferments, antispasmodics, sedatives of hyper-hyperistaltism. So
if everything went well, if the peristalsis has quieted down, let's try the
second course, which must be digestible, for example a slice of steamed or
roasted lacerine, tender and digestible. The fruit will be represented by some
apple, preferably cooked, initially, then you can try the pears, preferably
ripe. Avoid fruits like kiwis, plums, oranges, watermelons, pineapples, which
are deadly in irritable bowel syndrome variety with diarrhea! Avoid iced drinks,
strong tea, foods rich in fat and therefore difficult to digest; limit the
fructose and sorbitol intake with the diet (fruit juices), avoid alcohol, coffee
and substances that can aggravate any intolerances (dairy products, soy, gluten
excess, etc.). The effectiveness of lactic ferments is by many questioned; for
this reason it is recommended to talk about it in advance with your doctor; we
generally use lactic ferments in diarrheal syndromes, almost always successfully,
except for inflammatory bowel diseases. If you have irritable bowel syndrome, if
your tummy swollen gives you colic, you should cautiously consume these foods
with strong flatulogenic potential, that is, they ferment in the belly and give
off gas:
Milk and milk derivatives.
Vegetables: onions, beans, celery, carrots, Brussels sprouts generate intestinal
gas and meteorism
Fruit: raisins, bananas, apricots and plum juice.
La terapia del colon irritabile La visita del paziente con colon irritabile La cura della sindrome da colon irritabile: i farmaci La cura con le piante nella sindrome del colon irritabile dieta con le fibre La sindrome del colon irritabile varietà con stitichezza
cf indice di gastroenterologia