Irritable bowel syndrome (IBS)

IBS is one of the most common condition nowdays around. Quite often is ignored by the doctors or the person is adviced to just live with it. Most of the IBS conditions are related or triggered by something, and for most of them you can do something to help relieve it or eliminate it completly. The following are a brief explanation of what it is and what you can do for it.
IBS what is it?

IRRITABLE BOWEL SYNDROME

Irritable Bowel Syndrome, or IBS, is a gastro-intestinal disorder suffered by an increasing number of people. However, due to its multifactorial aetiology, IBS doesn’t have a single cause or treatment. (3,7). Many people diagnosed with IBS by their GPs are prescribed drugs that treat the symptoms, but unfortunately not the causes. There is, however, a range of non-pharmaceutical solutions that can successfully treat the disorder itself.

The following are typical, defining symptoms of IBS (3):

Abdominal pain or rumbling
Meteorism (a bloating sensation often combined with visible distension of the abdomen)
Nausea, indigestion and loss of appetite (4)
Flatulence, constipation and diarrhoea
Abnormal stool characteristics (6)
Mucus or slime in the stool (4)
The sensation of not empting the bowel properly (4)

Often, the intensity of the symptoms is most pronounced in the afternoon or evening. Incomplete or faulty digestion may aggravate the symptoms while defecation or passing flatus may provide some relief. The symptoms may come and go over a period of months (3)

Possible triggers of IBS
The following are some of the possible triggers that have been connected with the symptoms of IBS.
Food hypersensitivity or intolerances (1,7)
Emotional problems or stress (2,3 & 7)
Intestinal infections and inflammation caused by parasites or unfriendly bacteria. These can cause an increase in intestinal mucosal permeability (Leaky Gut Syndrome), which allows food and chemicals to enter the blood stream before they are properly digested. This can overload the immune system and cause an increase in the body’s inflammatory response, triggering mucosal sensitivity, abnormal motility and secretory response (8).
Dysbiosis (the imbalance between the good and bad bacteria in the intestinal tract).
Altered bowel flora. This can be the result of antibiotics, laxatives, diarrhoea or low dietary fibre.


Diet and Lifestyle.

Diet can have a strong modifying influence on the symptoms of IBS.

An increase in the intake of water and dietary fibre, mainly from fruit and vegetables, can be quite beneficial, as can a reduction in the consumption of diuretic beverages – tea, coffee and other caffeinated drinks (3).

Constipation, diarrhoea and dysbiosis (toxic bacteria) may be directly attributed to food sensitivities and intolerances (3).

Meteorism is caused by trapped intestinal gas, though the mechanism of this painful condition is not yet fully understood (3). Bacterial decomposition of lactose can increase the amounts of gas, leading to meteorism, intestinal rumbling, flatulence, bloating, diarrhoea or bowel movement immediately after consuming dairy products.

Psychologically, patients with IBS seem to experience more emotional disorders than non IBS sufferers (2,3). Anxiety neurosis, depression and other psychiatric disorders are most common, although it has yet to be indisputably established whether IBS leads to these disorders, or vice-versa. (3).

Food intolerances are thought to play a major role in the pathology of IBS. For example, people who are intolerant to lactose have been found to lack the enzyme needed to digest the sugar in dairy products. This can result in a bacterial fermentation of the sugar, creating an increase in hydrogen gas that may trigger certain IBS symptoms (1,3,5).

NB: IBS should be clinically diagnosed by your GP after he or she has conducted a series of tests to eliminate other possible causes of the symptoms. These may include taking a medical history, a physical examination, proctoscopy, routine blood tests (hemoglobin, sedimentation rate, white cell count, creatinine, aspartate aminotransferase, alkaline phosphatase) and urinary tests (glucose and protein). A barium enema is obligatory, except in young patients. A gynaecological examination and a lactose tolerance test should also be considered (3).


Possible natural treatments for IBS:

The symptoms of IBS can often be reduced by these modifications to the patient’s lifestyle (3):

Drinking 1-1/2 litres of pure water daily, in addition to usual beverage intake.
Reducing or eliminating tea, cocoa, chocolate, cola and alcohol.
Identifying and eliminating possible food sensitivities/allergies.
Increasing fibre intake by eating more fruit and vegetables (NB: eating raw foods can be a problem for some people).
Allowing time and privacy for bowel movements.
Reducing stress levels by finding ways to relax and cope with stressful situation.
Eliminate food that you react too (see NAET treatments)


When consulting patients who have been diagnosed with IBS, I begin by compiling a detailed account of the patient’s health and a family medical history and by requiring the patient to keep a food diary, recording daily food and drink intake and noting any symptoms that may have developed during the day. An assessment is then made as to whether food allergies or intolerances are aggravating the symptoms. I often recommend parasite and bacterial overgrowth testing to rule out any gastro-intestinal infections.

If it is agreed that emotional problems may be part of the cause, counseling by a qualified therapist or psychologist will be suggested

The treatment is collaboration between the client and the therapist. It is, therefore, vital that the client be committed to taking an active role in dealing with the disorder. In the case of food allergies or intolerances, the client should be aware that the elimination diet requires forgoing certain common foods and entails some sacrifices in normal eating habits. The client should also be prepared to introduce new foods to his or her diet.

If deemed necessary, I use a non-invasive muscle-energy allergy test to assess food allergies or intolerances. I also suggest private laboratory blood tests for food sensitivities/allergies, leaky gut, Candida overgrowth and other appropriate tests.


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Reference:
1 Bohmer C. J. M. 7 Tuynman H. A. R. E. (2001). The effect of a lactose-restricted diet in patients with a positive lactose tolerance test, earlier diagnosed as irritable bowel syndrome: a 5-year follow-up study. European Journal of Gastroenterology & Hepatology; 13: 941-944.
2 Douglas A. et al. (1988). Psychosocial factors in the irritable bowel syndrome. Gastroenterology; 95:701-8.
3 Krag E. (1985) Irritable bowel syndrome: current concepts and future trends. Scandinavic Journal of Gastroenterology; Suppl. 109: 107-15.
4 Stewart M. & Stewart A. (1994). No more IBS. London : Vermilion.
5 Vernia P., Di Camillo M. & Marinaro V. (2001). Digestive & Liver Disease; 33 (3): 234-9.
6 Yamada T., Alpers D. H. Laine L., Owyang C. and Powell D. W. (1999) (3rd ed). Gastroenterology (volume II). Phyladelphia: Lippincott Williams & Wilkins Publishers.
7 Zar S., Kumar D. and Benson M. J. (2001). Review article: food hypersensitivity and irritable bowel syndrome. Aliment Pharmacol Ther; 15: 149-449.

Bibliography:

Alun Jones V., Shorthouse M., McLaughlan P., Workman E. & Hunter J.O. (1982). Lancet; 1115-1117.
Chey W. Y et al. (2001). Colonic motility abnormality in patients with irritable bowel syndrome exhibiting abdominal pain and diarrhea. American College of Gastroenterology; 96 (5) 1499-1506.
Villanueva A., Dominguez-Munoz E. and Mearin F. (2001). Update in the therapeutic management of irritable bowel syndrome. Dig. Dis.; 19:244-250.