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:
- Irregularities in intestinal hormones/nerves responsible for peristalsis
- Bacterial, fungal or parasitic involvement
- Stress
- Infection/illness
- Poor nutrition (e.g., a low-fiber diet)
- Food allergy/sensitivity
- Gut irritants such as caffeine, nicotine
- Inadequate enzyme production
- Imbalance in intestinal flora (dysbiosis)
- Medications (e.g., antibiotics may destroy healthy gut bacteria)
- Undiagnosed lactose intolerance
- Alcohol consumption
 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:
- Onset of abdominal pain linked to more frequent bowel movements
- Looser stools associated with the onset of pain
- Relief of pain by passage of stool
- Noticeable abdominal bloating
- Feeling of incomplete evacuation more than 25% of the time
- Diarrhea with mucus more than 25% of the time
 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 restrictions
- Mecication
- Stress management
 DIET
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.
 MEDICATION
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.
STRESS MANAGEMENT
The following activities can help alleviate stress and thus help
manage IBS symptoms:
- Meditation/prayer
- Massage therapy/yoga
- Acupressure/acupuncture
- Biofeedback (measuring bodily functions in order to increase patient awareness)
- Colon hydrotherapy (a cleansing infusion of water into the colon)
- Chiropractic manipulation
- Music therapy
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:
-
Total-body Herbal Cleanse program with an added colon cleanse to
stimulate healthy bowel function and promote 2 to 3 healthy bowel movements
daily. Look for an advanced 30-day cleanse that supports the body’s 7 channels
of elimination, with bowel-stimulating herbs such as cape aloe and rhubarb.
-
Daily Fiber Supplement with a balance of both soluble and insoluble
fibers. Look for a flax-based fiber blend with added probiotics, amino acids,
and soothing herbal ingredients. Remember to increase fiber intake gradually.
-
Daily Essential Fatty Acid (EFA) Supplement with Omega-3 oils from fish
and flax, as well as Omega-6 to help lubricate the bowel and reduce intestinal
inflammation. Look for an oil blend with added lipase to enhance digestion.
-
Plant-derived Digestive Enzyme Supplement with protease, amylase, lipase
and other important enzymes, as well as soothing herbal ingredients and amino
acids. If stomach acid levels are low, you may wish to choose an enzyme
supplement with added hydrochloric acid (HCl).
-
Multi-strain Daily Probiotic Supplement with at least 6 billion active
cultures of health-promoting bacteria, including Bifidobacteria, Lactobacilli
and Lactococcus cultures. It should contain a minimum of 6 billion cultures.
IBS with Diarrhea
- Intestinal Support Formula containing L-glutamine and N-acetyl-glucosamine to
support a healthy mucosal lining and help relieve cramping and spasms. Look for
a 2-part product made with Western and Chinese herbs such as slippery elm and
fenugreek to help alleviate abdominal pain.
- Daily Soluble Fiber Supplement to
add bulk to the diet and promote healthy, well-formed stools.
- Daily Essential
Fatty Acid (EFA) Supplement with Omega-3 oils from fish and flax, as well as
Omega-6 to help lubricate the bowel and reduce intestinal inflammation. Look for
an oil blend with added lipase to enhance digestion.
- Multi-strain Daily
Probiotic Supplement with at least 6 billion active cultures of health-promoting
bacteria, including Bifidobacteria, Lactobacilli and Lactococcus cultures. It
should contain a minimum of 6 billion cultures.
- Plant-derived Digestive Enzyme
Supplement with protease, amylase, lipase and other important enzymes, as well
as soothing herbal ingredients and amino acids. If stomach acid levels are low,
you may wish to choose an enzyme supplement with added hydrochloric acid (HCl).
- Natural Anti-diarrheal Supplement made with antioxidant-rich rice bran fiber
helps add bulk to stools and relieve intestinal inflammation.
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