Irritable Bowel Syndrome (IBS)

IBS is challenging and painful condition that can last for years and cause a reduced quality of life. The good news is that relief is possible. Primarily by taking an integrated approach to treatment - focusing on the whole person, not just the symptoms of the disease- individuals can make effective lifestyle, diet, and supplement changes that can have profound effects toward alleviating IBS.

What is IBS?

The most challenging aspect of IBS is that it can’t be definitively diagnosed using a biological or chemical test. Rather, it is a collection of varying symptoms. The primary symptoms are abdominal pain and bowel dysfunction, including gas, diarrhea or Constipation, discomfort, Bloating, and Nausea. Most doctors diagnose IBS by ruling out other diseases and confirming symptoms. Diet, infection, and psychological stressors seem to underlie these symptoms for most patients with IBS.

What causes IBS?

Equally mysterious are the origins of IBS. Some research suggests that with IBS, the contractions of the colon that move food and waste through the intestines are abnormal, ranging from spasmodic to completely stopped. In the simplest sense, these abnormal contractions cause diarrhea and/or Constipation, as well as poor digestion and malnutrition. Further, they can indirectly lead to bacterial imbalance, compromised immunity, poor Metabolism, and changes in mood and hormonal activity.

Physical and mental stresses also are contributing factors, affecting contractions in the colon as well as the absorption of liquids and nutrients. People who have been exposed to psychological, physical, and/or sexual Trauma in childhood appear to be at higher risk of developing IBS. Approximately 20 percent of individuals may get IBS as the result of a parasite, infection, or other inflammation of the intestine.

For those affected, the medical solutions can be disheartening. Few prescription drugs exist, and what is available can have serious side effects. For example, alosetron hydrochloride (Lotronex), a prescription medication that has been prescribed to women with IBS, can cause severe Constipation and reduced blood flow to the colon. These effects have been associated with ischemic colitis, a critical condition of inflammation, irritation, and swelling of the large intestine.

Commonly used over-the-counter treatments have drawbacks as well. For example, one big mistake people with IBS make is taking too many antacids. Pain in the stomach and intestines doesn’t necessarily equate to too much acid. In fact, the opposite is often true.

A condition called hypochlorhydria, marked by insufficient levels of hydrochloric acid in the stomach, can cause maldigestion and symptoms of IBS. Additionally, many patients with Heartburn take antacids and other medicines, which further decrease acid production and compromise the Immune System. In a recent study, users of acid-suppressing medicines doubled their risk of pneumonia.

With acid suppression and chronic antibiotic usage, it’s possible for unhealthy bacteria to proliferate in the small intestine and result in a state known as small bowel bacteria overgrowth (SBBO) or dysbiosis. These problems of imbalanced bacteria can lead to decreased absorption of important nutrients and Vitamins. SBBO must be remedied with antibiotics or anti-microbial Herbs.

Beyond what’s found at the pharmacy, certain behaviors will usually worsen IBS, including eating large meals; taking big doses of medications; and consuming wheat, milk products, chocolate, caffeine, and alcohol. Stressors, both physical and mental, also are common aggravators.

A properly functioning Digestive System is a finely tuned physiological machine that runs the tasks of digestion and nutrient absorption, immune regulation, Metabolism, and certain hormonal balances. Untreated, IBS can have profound negative effects on the whole body.

Nearly 70 percent of the Immune System is located in the digestive tract. At birth, the intestines are sterile, but within two years, they become home to more than 100 trillion bacteria. These bacteria play a crucial role in the maintenance of the Immune System, fending off pathogens and keeping the gut in balance. IBS can throw off the bacterial balance in the intestines, compromise the Immune System, and affect overall health and wellness.

Digestion - breaking down food, absorbing nutrients, and expelling waste - is also compromised with IBS. When the intestines don’t digest properly, it’s hard to get sufficient nutrients, and a state of slow malnourishment is created. Sometimes, a leaky gut can result, causing undigested food to escape the small intestine, enter the blood stream, and cause Allergy, inflammation, and Stress in the liver.

What you can do now

Unfortunately, there’s no cure for IBS, no magic pill or prescription. But there are several things that you can do to start feeling better right away. Following are some of the best ways to help minimize flare-ups and keep your intestines as healthy as possible.

  • Chew. It sounds obvious, but proper chewing is the first step toward good digestion. Gobbling down chunks of food is hard enough on healthy stomach and intestines, but it’s even harder if you have IBS. Digestion starts in the mouth, so take your time and chew completely before swallowing. Each part of the digestive tract needs time to do its work without being overwhelmed. Also, avoid overeating. Eating too much food puts tremendous physical Stress on the Digestive System.

  • Eat right. Eat a hypoallergenic diet of whole foods and drink lots of water to keep the intestines hydrated. Eliminate-or at least reduce-refined carbohydrates and sugars. Honey and syrup appear to be better than sucrose, which is better than fructose. Excess consumption of trans fats can cause irritation and irregular contractions in the intestines. Opt for moderate servings of healthy fats found in foods such as Olive Oil, flaxseed oil, Avocado, salmon, and chopped nuts.

  • Steer clear of caffeine and coffee. Not only will caffeine shock the intestines, but as a central Nervous system stimulant, it will add Stress to your whole body.

  • Be careful with dairy. Milk, cheese, and other dairy products are notorious for aggravating the bowels and causing diarrhea or Constipation, gas, Bloating, and Nausea. This may be due to lactose-intolerance, or it may be a reaction to cow’s-milk Proteins. Some over-over-the counter medications will help the former; abstinence will help the latter. Most plain yogurts are OK.

  • Watch out for wheat and other gluten-containing starches. These too can aggravate the intestines and trigger food sensitivities and Allergies. In some cases, potential IBS suffers may in fact have celiac disease, otherwise known as gluten sensitivity. The symptoms are similar, including diarrhea and discomfort, but with celiac disease, gluten can cause serious damage to the intestinal lining. In this case, abstaining from gluten is the only option. A simple blood test can help diagnose celiac disease.

  • Don’t neutralize yourself. Avoid or eliminate antacids. If you’re eating right, you shouldn’t have an excess acid problem. IBS is not Heartburn, so taking antacids won’t bring true relief. Also eliminate proton pump inhibitors - acid suppression drugs used to treat ulcers - and Antihistamines, which reduce acid levels. These too will slow digestion and worsen IBS by creating dysbiosis.

  • Exercise. Just like the other muscles in the body, the intestines are toned and regulated by moderate, regular Exercise. Over time, doctors have observed that people who don’t Exercise tend to have more sluggish bowels, which, in turn, exacerbates IBS.

  • Take probiotics. This is a must for anyone with IBS. Regardless of the causes of your condition, the balance of good bacteria in your intestines is probably precarious at best. Supplementing with a combination of lactobacillus and bifidobacteria is one of the most effective AIDS for the digestive tract. Recent research suggests taking at least 50 to 100 billion cfu (colony forming units) daily for IBS. For intestinal recovery after a cycle of antibiotics, take 20 to 40 billions cfu daily. Refrigerated cultures are preferred over unrefrigerated pills and powders. Home-made yogurt is an excellent source of probiotics, but commercial yogurts often have much lower counts.

Specific remedies

Considering again an integrated approach to treatment, related complications may be present and need to be addressed with the help of a health practitioner.

  • IBS sufferers with pancreatic insufficiency should supplement with pancreatic enzymes.

  • A person with insufficient bile should drink lots of water and take supplements that help the body use fat, such as milk thistle, taurine, and selenium. These support the liver and the communication between the liver and the colon, helping the body maintain proper bile levels and fat absorption rates.

  • A person who has parasites or other microorganisms can benefit from anti-parasitic Herbs such as black walnut, wormwood, Goldenseal, and oil of Oregano. Oftentimes, additional drug treatment is necessary; new medicines are now available in the United States.

  • If you have yeast overgrowth, limit sugar, flour, and refined grains. Take vitamin B6 in combination with Anti-Fungal supplements. If conditions persist, more aggressive treatment with antifungals may be necessary.

  • If you have bacterial overgrowth, support stomach acid, and avoid acid suppression therapies. If conditions persist for more than four to six weeks after beginning to use those tactics, antimicrobial Herbs or antibiotics (along with probiotics) may be necessary.

  • For nutrient deficiency and poor nutrition, supplement with Vitamins and minerals. Generally people with IBS have low levels of B Vitamins, which are absorbed at the end of the small intestine, the location of bacterial overgrowth. Supplementation with B-complex and a multivitamin is important and useful. Occasionally additional B-12 is also necessary.

Inflammation from infection, food Allergies, or dysbiosis may also damage the intestinal villi, the microscopic projections in the lining of the gastrointestinal tract that absorb nutrients and carry them to the blood. L-glutamine is effective at healing and repairing the villi, but it is essential to remedy the underlying problems first. L-glutamine can be used as a source of food by unwanted bacteria and yeast. It should only be taken as a restorative after the other conditions have been treated.

Many times, psychological and Stress disorders get better with an improved diet and proper treatment of an individual’s underlying causes, but for serious or stubborn issues, professional counseling and Stress management are helpful in controlling IBS symptoms.

Getting through to the other side

Because IBS is a collection of different symptoms that affect individuals in varying forms and intensity, it’s nearly impossible to prescribe a blanket protocol for treatment and management of the condition. The best approach is to first start with the basics.

Begin with the dietary changes; take out common food Allergens like milk and wheat, and experiment to find out what other foods may cause you trouble. Stay away from the simple sugars, which can act as a food source for unwanted bacteria. Avoid caffeine, trans fats, refined carbohydrates, acid suppressants, and large meals.

Most people should see significant improvement after following these guidelines. If you make these changes and still don’t feel better, consult a healthcare practitioner for an in-depth examination to rule out infection, parasites, inflammation, or other disease processes.

Each case of IBS is a unique collection of symptoms and causes, an imbalance in the Digestive System that can be effectively corrected by the individual, sometimes with the help of a healthcare practitioner who understands diet and nutrition. Take the integrative approach, and trust your gut. IBS is signal of imbalance; improvement in your gut will help you to feel healthy from the inside, out.

Do You Have IBS?

If you go to a doctor to find out if you have IBS, the doctor will consider the Rome Criteria, which is the following checklist of typical symptoms. For a quick self-check, see the list below, but don’t consider this a replacement for a visit to your healthcare practitioner.

ROME II SYMPTOM CRITERIA FOR IBS

In the past 12 months, experiencing at least 12 weeks (not necessarily consecutive) of abdominal discomfort or pain that has two out of three of the following features:

1) Discomfort is relieved with defecation.

2) Onset is associated with a change in frequency of stool.

3) Onset is associated with a change in form appearance of stool.

Other symptoms that are not essential but support the diagnosis of IBS include the following:

  • Abnormal stool frequency (more than three Bowel Movements a day or fewer than three Bowel Movements a week)

  • Abnormal stool form (lumpy/hard or loose/watery stool)

  • Abnormal stool passage (straining, urgency, or feeling of incomplete evacuation)

  • Passage of mucus

  • Bloating or feeling of abdominal distension

Symptoms in the Rome Criteria are not the only indicators of IBS.

Non-intestinal symptoms include the following:

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