What is IBS and how can it be managed?

Henrietta Norton BSc, Dip NT, MBANT, AFMCP Co-founder of Wild Nutrition and Nutritional Therapist.

Statistics tell us that at least a third of us are affected by Irritable Bowel Syndrome (IBS) at some time during our life and if I had a pound for every client I have seen with a diagnosis of IBS by their GP I would be a very wealthy nutritionist. I would be even wealthier if I put money on the fact that by the time they left their GP’s surgery they still didn’t know what IBS was, and what they themselves can do about it.

I can’t help but get hot under the collar about IBS. To me IBS is not a condition; it is a cluster of symptoms that, if the cause is not found, can lead to a condition such as diverticulitis or inflammatory bowel disease. IBS is often called ‘a functional disorder’ of the bowel; in other words, a disturbance in bowel function without any change in structure or obvious cause. When diagnostic tests such as blood tests or endoscopies are carried out the results do not reveal any obvious abnormality. It is at this point in the ‘patient handling’ that I start getting rosy around the neck and where treatment tends to conclude with a label of IBS, maybe a quick chat about reducing bloating with a pill, and a leaflet about stress relief.  Few patients are left feeling empowered or informed about what they can do to manage this issue when in fact there is much that can be done.

So first things first, what is IBS?

According to medical criteria, in order to diagnose IBS, there must be at least 12 weeks (which need not be consecutive) in the preceding year of abdominal discomfort or pain characterized by a minimum of two of the following fundamental three features:

  • It is relieved by defecation.
  • It’s onset is associated with a change in frequency of stool.
  • It’s onset is associated with a change in appearance of stool.

The following symptoms also cumulatively support the diagnosis of IBS

  • Fewer than three bowel movements a week
  • More than three bowel movements a day
  • Hard or lumpy stools
  • Loose or watery stools
  • Straining during a bowel movement
  • Needing to urgently rush to the loo
  • Rumbling noises and excessive passage of wind
  • Sharp pain felt low down inside the rectum
  • Abdominal pain that is relieved by going to the loo
  • A feeling of ‘not quite getting it all out’, incomplete bowel movement
  • Mucus (a white sticky or stringy substance) is present in or around the stool
  • A feeling of fullness, bloating or swelling in the abdomen
  • Other symptoms frequently reported are: headaches, dizziness, backache, passing urine frequently, tiredness, muscle and joint pains, indigestion, nausea, shortness of breath, anxiety and depression.

The modern diets and busy lifestyles that we lead can leave us all vulnerable to some of the above at times but the cumulative effect of many of these symptoms together can lead to an IBS diagnosis.

What you can do to help yourself?

What all these symptoms have in common is that they relate to a disturbance of the colon or large intestine although there is no reported physical abnormality and therefore no physical ‘cause’ as such. However there is much that can be done effectively and naturally to address the symptoms and each person’s experience of this health phenomenon.

5 primary areas of focus for natural treatment

1. Increasing dietary fibre

This is recommended to those IBS sufferers who experience constipation. The type of fibre most commonly recommended is wheat bran. However as those with digestive vulnerability, such as those with IBS, have a heightened chance of developing a food allergy wheat bran is in fact not the optimum form of fibre. Instead choose fruit (stewed for easier digestion) and vegetable sources such as apples, pears, figs, green leafy vegetables or root vegetables such as squash or beetroot. These are also dense in antioxidants needed to heal the inflamed gut wall. Include at least two varieties of fibre with every meal to boost your intake.

2. Eliminating allergenic foods

The most recent studies on IBS have further documented the association between food allergy and an irritable bowel. According to a double blind challenge, the majority of patients with IBS (approx two-thirds) have at least one food allergy and some have multiple allergies! The most common of these being dairy and grains. If you think this could be your problem, consult a nutritionist for a food allergy test and elimination diet.

3. Removing sugar from the diet

Meals high in sugar encourage small intestine bacterial overgrowth by decreasing intestinal motility (the bit that keeps the rhythmic flow in the gut wall so that food passes effectively through the gut). It also causes the glucose running through our bloodstream (also known as blood sugar levels) to rocket and when this happens it causes this muscular rhythmic flow to slow down even further. This in effect causes muscular paralysis in the gut and food matter becoming sitting tenants. The answer is to remove refined sugar (that’s the packaged Tate & Lyle stuff) and all its products such as confectionary and pastries and replace with small amounts of local honey or maple syrup to wean yourself off your sweet tooth.

4. Addressing psychological factors that could be controlling your health

This is a tricky one. Many of us live a very busy life and because we ‘manage’ it day in and day out we may grow used to the stress that it brings with it. Unfortunately we are not always aware that our emotional and physical health is not managing this lifestyle quite so well and as a result conditions such as IBS can develop. Increased motility (the rhythmic flow again) of the colon in the gut, during exposure to stressful situations, has been shown to occur in those with IBS. The gut is also known as the ‘second brain’ because it has many of the neurotransmitters also found in the brain. This explains well the idea of having ‘butterflies in your tummy’ or a ‘gut instinct’ and further explains the link between emotions and gut function. Psychotherapy in the form of relaxation therapy, biofeedback, counselling or stress management training has been shown to reduce symptoms of IBS. Deep breathing is not only relaxing but provides the body with a greater source of oxygen for healing.

5. Supporting ourselves with food supplements

Sometimes the gut could do with a helping hand and the following nutritional supplements have been shown to be of much benefit:

Enteric coated peppermint oil preparations (0.2-0.4ml) twice per day between meals.
Fibre supplements (such as psyllium husks) 3-5 grams per day before bed and with plenty of water. This has been shown to be effective in patients with both constipation and/or diarrhoea.
Lactobacillus acidophilus or lactobacillus plantarum. Our Multi-Strain Biotic is an excellent unique formula, containing 8 strains of bacteria.
Artichoke supplements produced an overall reduction in IBS symptoms in 71% within an average of ten days in a recent study. Take 320mg of Artichoke extract 3 times per day.

Despite more research and public awareness of IBS, no cure has been found. Medical treatment may vary from advice on diet and relaxation, to the use of anti-spasmodic drugs and low dose antidepressants. Some find help from counsellors or psychotherapists, some from practitioners of complementary medicine – such as acupuncturists or hypnotherapists. As many people with IBS feel out of control with what they can do, I hope that by making informed diet and lifestyle choices you will see that in fact you can make a real difference to your experience of IBS.

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