INTRODUCTION
Acne vulgaris is a chronic inflammatory disease of the pilosebaceous
unit and is characterized by seborrhea, open/closed comedones, papules,
pustules and nodulocystic lesions(1). The cause of acne vulgaris
increased sebaceous gland activity, abnormal follicular hyper
keratinization, microbial hyper-colonization of the follicular canal and
increased inflammation(2). Lifestyle, diet, testosterone levels,
gastrointestinal dysfunction, bacterial infection, and psychological
factors play a role in the pathogenesis and development of acne.
Exercise, even moderate activity such as walking, can help to treat both
constipation and acne(3). Another disease affecting the brain and
intestinal axis by inflammatory process is irritable bowel syndrome.
Irritable bowel syndrome (IBS) is the most commonly diagnosed disease
without an underlying organic pathology, characterized by the presence
of abdominal pain or discomfort with variable bowel habits (4). Its
prevalence is generally between 12–30% (5). IBS symptoms are
identified in four subtypes according to Rome III criteria. Bristol
Stool Scale (25) provides information about the consistency, thickness
and amount of stool. Studies reveal that IBS is more common in women
than men (6). IBS has been considered a brain-intestinal disease. In
susceptible individuals (for example, those with a genetic
predisposition or exposed to environmental factors), the association
with psychological stress (eg anxiety, depression or somatization) and
an infectious or inflammatory response can alter intestinal
permeability, contributing to the onset of IBS symptoms (7). Depression
and somatization can also lead to the development of IBS symptoms by
mediating changes in intestinal permeability, immune system, and
microbiome (7). Localized inflammation develops as the intestinal
permeability increases, and then the number of inflammatory cells
(histamine, tryptase, serotonin, TNF-, proteases and interleukins)
increases (7). Although there are many data on acne and microbiota in
the literature, data on acne and intestinal habits have not been
determined. Normal functioning of gastrointestinal tract can influence
benefit from oral treatment besides adverse events (7). The aim of this
study is to evaluate the impact of bowel habits, IBS, physical activity,
and dietary fiber intake in acne vulgaris patients.