Irritable Bowel Syndrome (IBS)
What Is It?
Irritable Bowel Syndrome (IBS) is considered a functional disorder of the colon, or large intestine. With IBS, the large intestine ceases to function properly even though there is no evidence of any organic structural abnormality. Although the condition is often confused with colitis, this is technically incorrect, as IBS symptoms do not typically include inflammation, ulceration or other tissue changes. The cause of IBS is not yet fully understood, but some scientists believe it is a disorder of the enteric nervous system, in which the nerves along the gut alter normal pain perception so that the bowel becomes oversensitive to normal stimuli.
IBS is at least partially a disorder of colon motility. In it, the normally rhythmic muscle contractions that move food through the digestive tract (peristalsis) become irregular and uncoordinated. This interferes with the movement of food and waste and leads to the accumulation of mucus and toxins in the intestines. As the accumulated waste material builds up in the digestive tract, it causes an obstruction that traps gas and stools. The result is increased bloating, pressure and constipation.
What Causes it?
Scientists believe some of the following factors may play a causative role in the development of the condition:
Who Gets It?
IBS is among the most common gastrointestinal disorders seen by physicians and accounts for roughly 3.5 million office visits yearly in the United States. An estimated one out of every five Americans suffers from IBS, and the average age of onset is between 25 and 45 years, with prevalence of the disease declining with age.
Signs and Symptoms
Physicians worldwide work continually to establish a set of criteria by which IBS can be defined and diagnosed. One of the most widely used is the Manning Criteria:
How Is IBS Diagnosed
Identifying IBS involves a “diagnosis of exclusion,” which means the diagnosis is largely the result of ruling out other disorders that may have the same or similar symptoms. These include colon cancer, diverticular disease, inflammatory bowel disease (Crohn’s disease and ulcerative colitis), lactose intolerance, candidiasis, celiac disease, diabetes, and gall bladder disease. A thorough medical history and physical examination, along with appropriate laboratory tests (blood tests and stool exam), will help to rule out other disorders, and doctors may also perform an endoscopic procedure such as a colonoscopy or a sigmoidoscopy to visually inspect the colon. A tissue biopsy may also be taken in conjunction with the endoscopic procedure.
How is IBS Treated?
Treatment of IBS typically includes both conventional (standard) medical treatment, as well as natural remedies such as the use of herbal supplementation and stress management. The three main facets of IBS treatment are:
Dietary advice typically begins with avoiding caffeinated foods and beverages (coffee, tea, cola, chocolate, etc.) and reducing alcohol consumption. Blood tests or an elimination diet may be necessary to pinpoint food allergies or sensitivities, and many physicians recommend keeping a diet journal to help identify irritating foods. In order to rule out lactose intolerance, some doctors recommend eliminating dairy products for at least a 2-week trial basis. Similarly, a 2-week trial elimination of grains may be recommended to rule out celiac disease and/or gluten sensitivity. In cases of severe diarrhea, IBS sufferers are often prescribed a BRAT diet, which consists of bananas, rice, applesauce and tea. Organic foods are also recommended whenever possible.
Also with regard to diet, the majority of health care practitioners will advise IBS patients to increase their intake of dietary fiber, since fiber supports bowel regularity and overall gastrointestinal health. However, adding more fiber to the diet should be done gradually in order to avoid aggravating IBS symptoms, and patients may wish to avoid fibers made from wheat bran due to the high allergy potential of wheat.
Doctors may prescribe several types of drugs to help alleviate IBS symptoms, including anticholinergic and antispasmodic drugs to help regulate intestinal contractions, antibiotics to treat infection (if present), antacids, and stool softeners to help relieve constipation. Antidepressants may also be prescribed to help filter out painful stimuli from the gut to the brain, and tranquilizing drugs may help with overall relaxation. As with most prescription drugs, however, many of these may have adverse side effects that can worsen GI symptoms, depending upon the individual IBS sufferer. Frequently, herbal remedies are used with equal benefit and without the unwanted side effects. These can be quite effective in combination with dietary management and regular exercise to help control the symptoms of IBS.
The following activities can help alleviate stress and thus help manage IBS symptoms:
Nutritional Supplement Suggestions
Nutritional supplementation has proven effective for the relief and reduction of IBS symptoms. The following two supplement protocols are for IBS involving constipation and IBS involving diarrhea.
IBS with Constipation
Those with constipation IBS should follow a 30-day herbal detox program. This will consist of: