Are diets the answers to colon ills? Food, irritable bowel syndrome and the microbiome

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Given the role of the gastrointestinal tract in digestion and absorption, it is appropriate that food or the very anticipation of food should be the primary trigger of many physiological processes in the gut and its related organs – from lower esophageal sphincter relaxation to pancreatic secretion and colonic motility. Indeed, the gastro-colonic response, recognized many years ago, has been confirmed as a major motor response in that organ and described in great detail on recent high-resolution manometric studies of the colon [1]. Our patients have been telling us forever that food is a major trigger of their irritable bowel syndrome (IBS) symptoms [2], yet we ignored them; that is until recently. In the meantime and lacking any interest from us, their gastroenterologists, these sufferers embarked on any number of dietary exclusions and supplements in the belief that they had an ‘allergy’ to certain foods or that some supplement recommended by a family member, friend, magazine or website would help. These dietary excursions were usually undertaken without supervision and could lead to adverse nutritional consequences [3].
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