Irritable Bowel Syndrome, or IBS, is a gastro-intestinal disorder suffered by an increasing number of people.

However, due to its multifactoral 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

• Bloating sensation often combined with visible distension of the abdomen (called Meteorism)

• 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 caffenated drinks (3).

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

Meteorism (bloating and associated symptoms) 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, a 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 one-and-a-half litres of pure water daily, in addition to usual beverage intake.

• Flax oil, 5ml daily with food

• Take a good quality probiotic supplement

• 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.

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.  A hair analysis is always carried out determine underlying factors that may influence the patients health.  Included in the test is parasite and bacterial overgrowth testing to rule out any gastro-intestinal infections. I also use hair analysis for food sensitivities/allergies, leaky gut, Candida overgrowth and other appropriate tests. An assessment is then made as to whether food allergies or intolerances are aggravating the symptoms.

If it is agreed that emotional problems may be part of the cause, treatment using gem or flower essences are used as well as relaxation treatment.

The treatment is a 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 usea combination of homeopathic, supplementation, Chinese herbal medicine and needle free electro-acupuncture to rebalance the system

References:

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) (3^rd 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:

1. Alun Jones V., Shorthouse M., McLaughlan P., Workman E. & Hunter J.O. (1982).  Lancet; 1115-1117.
2. 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.
3. Villanueva A., Dominguez-Munoz E. and Mearin F. (2001). Update in the therapeutic management of irritable bowel syndrome. Dig. Dis.; 19:244-250.