New Research: Potential Cause of Post-Infectious IBS Identified
In January, the results of an exciting research study were posted that looked into possible causes for IBS for people who have the onset of the syndrome after a gastrointestinal infection (a.k.a. post-infectious IBS).
An estimated 17% of people report the onset of their irritable bowel syndrome as being after a GI-infection.
A large portion of our immune system resides in our gut, and it works to balance out the immune response between actual pathogens and the harmless “good gut” bacteria and antigens from our food. This is to limit an immune response, like inflammation, when such a response isn’t needed. In a healthy gut, our immune system isn’t getting trigger by foods that we eat.
What this study showed, is that during a GI-infection, the presence of particular foods in the gut could lead to a sensitivity for that food even after the infection has been cleared.
The researchers infected mice with a bacterial gastrointestinal infection, while at the same time feeding them a solution containing ovalbumin, a protein that is found in egg whites.
After the infection was cleared, they continued giving the mice ovalbumin challenges and saw that an immune response was provoked. The mast cells in the gut were activated, released histamine, and led to IBS-like symptoms in the mice (diarrhea, reduced GI transit time, increased fecal water content). This didn’t happen in the mice who received ovalbumin but did not have the GI-infection.
Visceral hypersensitivity (VHS) is another key symptom of IBS, essentially meaning that the pain perception in the gut is heightened for people with IBS than those without. In the mice study, overall VHS was heightened for 4 weeks after the GI-infection was cleared. At 5-weeks, VHS was observed when the mice were given the ovalbumin, but was not present when other, similar, antigens were given.
Finally, the researchers tested for this immune response in 12 people with IBS, by injecting food antigens (from gluten, milk, soy, or wheat) into the gut wall. They observe the same immune responses in these people as in the mice for at least one of the food antigens each.
What does this mean going forward and for me and my IBS management?
Considering the small number of participants in this study, much more research is still needed, and indeed there are still ongoing studies following up on this topic.
Not everyone with IBS reports its onset as after a GI-infection, so this doesn’t necessary answer all of the questions that are pending about IBS and may not be relevant for everyone. And as we know, there are many other factors often at play when it comes to IBS symptoms being triggered (like stress, poor sleep, etc.).
But if you do have the post-infectious subtype of IBS, this research would be very interesting to discuss with your healthcare providers especially in terms of potential irritable bowel syndrome management options.
And in any case, all research and innovation in this field is extremely exciting, especially considering that potentially up to 20% of the population may struggle with irritable bowel syndrome.
Read more about the research:
Aguilera-Lizarraga, J., Florens, M.V., Viola, M.F. et al. Local immune response to food antigens drives meal-induced abdominal pain. Nature (2021).
Click here for the press release about this study from KU Leuven
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