Eschborn – Around 10 to 15 percent of the population in this country are considered irritable bowel syndrome (IBS) patients. Their suffering is exacerbated by a blatant lack of care: “Around three quarters of those affected do not receive any treatment and the correct diagnosis is made either too rarely or too late,” warned S3-RDS guideline author Prof. Dr. in 2022. med. Ahmed Madisch, Center Gastroenterology Bethanien, Frankfurt1. Given this deficit, a deeper diagnostic look into the gastrointestinal tract appears to be the currently appropriate recommendation, because: “We assume that at least 70 percent of patients with irritable bowel syndrome have a disorder of the intestinal barrier,”2 explains gastroenterologist Prof. Dr. med. Jost Langhorst, S3-RDS-LL author, Bamberg Social Foundation. Dr. reports the same experiences. med. Marc Werner, Director of the Clinic for Naturopathy & Integrative Medicine, Essen-Mitte Clinic. “A leaky gut3 is also found in around 70 percent of patients with irritable bowel syndrome.” To stabilize the intestinal mucosa, Langhorst prescribes a phytopharmaceutical to patients with a disturbed intestinal barrier – based on the following scientific rationale: “There is good data from basic research that shows that Myrrh stabilizes the intestinal barrier. At our clinic we use a preparation made from myrrh, chamomile and coffee charcoal*2.”
Before therapy comes the diagnosis. This is where the most modern intestinal barrier diagnostic technology is available, which to date has only been carried out at 13 gastroenterological centers4 across Germany:
Confocal Laser Endomicroscopy – High-Tech Gut Screening
Using confocal laser endomicroscopy (KLE), gastroenterologists can accurately diagnose at 1,000x magnification whether there is a disruption in the intestinal barrier (see illustration). Therefore, an expansion of this precise medical technology seems to make sense in order to gradually force a diagnostic paradigm shift towards KLE – also under the premise that “the most well-established common denominator, which probably triggers or intensifies all of the different irritable bowel symptoms, is a barrier disorder in the intestinal mucosa,” says gastroenterologist Prof. Peter Layer, coordinator of the new S3-RDS-LL5:
Intestinal Barrier Consensus 2022
Already in March 2022, six gastroenterological specialists from clinics, practice and science (see photo below) discussed in Frankfurt a. M. the importance of the intestinal barrier in various diseases and its current diagnostic and therapeutic options. The consensus: Today, not only are a variety of intestinal dysfunctions and diseases such as irritable bowel syndrome (IBS), chronic inflammatory bowel disease (IBD), celiac disease or food allergies associated with an impaired intestinal barrier – extra-intestinal diseases such as migraines or inflammatory dermatoses are also often correlated with this.
Therapeutic target intestinal barrier
The focus of therapy is currently on alleviating symptoms of the respective intestinal disease in accordance with guidelines. However, a recognized intestinal barrier damage could influence the course of therapy or the selection of the therapeutic agent, as the underlying permeability disorder can be relevant to the symptoms. According to a panel of experts, the currently available barrier-protective therapy concepts include intestinal stabilizing6,7, anti-inflammatory8-12 and simultaneously symptom-relieving phytopharmaceuticals such as Myrrhinil-Intest* (for the synchronous supportive treatment of diarrhea, flatulence and intestinal spasms) as well as probiotics, zinc and vitamin D.
German intestinal barrier research: increasing commitment
Due to its continuously growing relevance, German research institutions13 have been conducting ongoing research into the intestinal barrier for many years – this year alone (2023), scientists from the following institutes, among others, have published current studies in which the intestinal barrier was also discussed: University Medicine at Johannes Gutenberg University Mainz , Julius Maximilian University of Würzburg, Kaiserslautern University of Applied Sciences, Leibniz Institute for Aging Research – Fritz Lipmann Institute e. v.
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