What is spastic colitis and how is it treated?

What is spastic?

Spastic colitis (or Irritable Bowel Syndrome more properly, as the term colitis refers to the presence of inflammation, which is absent in this disorder) is a functional bowel disorder characterized by changes in bowel emptying habits without any organic disease, chronic abdominal distension (bloating) and discomfort.

It can occur in the form of diarrhea or constipation, and there is often an alternation between the two. This syndrome affects 11-14% of the adult population and mainly women worldwide, while the causes have not yet been elucidated. It may be caused by an infection or by diet, and it has been suggested that it may be a psychophysiological phenomenon.

– Do I have spastic colitis?

Criteria for irritable bowel syndrome (Rome III) have been defined for the correct diagnosis:

Abdominal pain or discomfort for at least 12 weeks in the previous 12 months. These 12 weeks do not have to be consecutive.

Abdominal pain or discomfort should have 2 of the following 3 characteristics:

  • They relieve during defecation.
  • When they start, there is a change in the frequency of defecation.
  • When they begin, there is a change in the shape of the stool and how they look.

The diagnosis is made by a gastroenterologist differentially, i.e. rejecting other diseases that have similar symptoms, such as infections, lactose intolerance, gluten intolerance, bowel cancer, etc.

– How are the symptoms relieved? Can diet help?

The gastroenterologist often prescribes medications for spastic colitis, but 70% of patients with irritable bowel syndrome do not receive any medication and the relief of symptoms is through diet.

  • Foods that affect the severity of symptoms are different in each patient. For this reason, the first thing a person suffering from this syndrome should do is keep a diary of food intake and gastrointestinal habits. In this way those foods that increase or decrease the symptoms can be identified and the diet can be adjusted accordingly. It should be emphasized, however, that although a food, e.g. whole meal bread can cause symptoms, this does not mean that it should be completely excluded from the diet because if this happens to all the foods that bother you, then the diet may become inadequate. Foods that exacerbate the problem should be replaced by others with similar characteristics that will not reduce the quality of the diet.
  • A major source of spastic colitis are plant fibers. For these patients, who are dominated by constipation, an increase in the intake of plant fibers and in particular solvents (i.e. those found in legumes, oats, barley, fruits and vegetables) can relieve symptoms, as long as combined with an increase in water intake. Insoluble plant fibers (that are those found in whole grain products) don’t seem to help the irritable bowel. In these patients with predominant diarrhea, plant fibers should not be increased.
  • The most commonly blamed foods are caffeine, lactose (milk sugar), gluten (grain protein) and fructose.
  • Small and frequent meals have been shown to help with symptoms and are recommended in contrast to messy, large and “heavy” meals, i.e. high-fat meals.
  • Taking probiotics can help the irritable bowel. Try yogurts or other probiotic foods on the market and see if they can improve your symptoms.

– Beyond diet?

Stress has been blamed for exacerbating the symptoms of irritable bowel syndrome. Thus, stress reduction techniques can be applied to patients and lead to reduced symptoms.

Exercise has also been shown to have effects in relieving patients. Walk vigorously or do some aerobic exercise (treadmill, bike, aerobics).

Advises Ms. Dimitra Meladaki, Clinical Dietitian – Nutritionist MSc

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