Irritable Bowel Syndrome

Latest Edit: Hector 2014-05-15 (EDT)

Irritable Bowel Syndrome

Irritable Bowel Syndrome
Causes	Dietary Factors, Infections, Alcohol, Stress, Smoking
See Also	Digestive Conditions, Dysbiosis, Heartburn, Lactose Intolerance, Hypochlorhydria, Inflammatory Bowel Disease, Crohn's Disease Ulcerative Colitis
Books	Books on Digestive and Liver Conditions
Articles	Articles on Digestive Conditions

Article	IBS Cross Talk, The Mystery Solved?, NDNR [1], 2012 January

Irritable Bowel Syndrome (IBS) is a bowel condition that is associated with a number of different digestive symptoms. It is considered a motility disorder that involves both the small and large intestines. It is the most common functional bowel disorder, affecting upto 20% of the population and can greatly effect quality of life.

Naturopathic Assessment

Causal Factors

In order to stimulate the innate ability of the body to heal the causes of disease must be identified and addressed. Irritable Bowel Disease, like may conditions, most likely is the result of a combination of effects including exposure to pathogens, imbalanced bacterial flora, poor dietary choices and stress triggers which combined can result in a state of immune system dysregulation. A detailed assessment is required to determine which factors are contributing to both the onset and the aggravation of IBS.

Check out this book	IBS For Dummies

Lifestyle

• Dietary Factors

• Food allergies and food intolerances are commonly associated with IBS. Food reactions may be the main pathogenic factor in upwards of 2/3 of patients.,

• The most common foods that tender to initiate or aggravate IBS include wheat, corn, dairy, coffee, tea, and citrus fruit.
• Lactose Intolerance tends to associated with IBS.

Article	Fructose Intolerance, Irritable Bowel Syndrome, and the FODMAP diet, NDNR; 2013 January

• An excessive intake of pepper and cold food is associated with increased risk of IBS.
• Over indulgence in bran may be associated with IBS.

• Alcohol

• Alcohol consumption is positively correlated with IBS.

Social

• Stress

• Presence of anxiety disorders, depression, and somatization are all strongly correlated with IBS.
• A history of early trauma, including sexual or physical abuse may predispose a person to IBS.

• Family Dynamics

• Children who grew up in an affluent household or in a single-parent household tend to have a greater risk of IBS.

Environmental

• Infections

• IBS can also develop in an individual following an acute episode of a gastrointestinal infection with pathogens such as: Campylobacter sp, Clostridium perfringens, Staphylococcus aureus, Bacillus cereus, Shigella and viruses.
• Intestinal candidiasis is correlated with increased occurrence of IBS.
• Other protozoal infections associated with IBS include: Giardia, Blastocystis hominus and Cyclospora

• Climate

• Exposed to low temperatures is associated with the occurrence or aggravation of IBS.

External

• Smoking

• Smoking especially among children and adolescents can trigger IBS.

Medical Interventions

• Prescription Medications

• The overuse of antibiotics, antacids and laxatives is strongly correlated with an increased prevalence of IBS.
• Other medications associated with IBS include: oral contraceptives or glucocorticoids.

Genetics

• Family History

• Twin studies show that the concordance for IBS in identical (monozygotic) twins is significantly higher than in fraternal (dizygotic) twins, therefore suggesting a genetic component.

• Gender

• Women are three times as likely as men to develop IBS. IBS is also more common in those under the age of 45.

Common Questions

• What are your symptoms?

• Abdominal pain? Bloating? Gas? Constipation? Diarrhea?

• What makes your symptoms worse?

• Certain foods? Eating in general? Stress?

• Does having a bowel movement improve your symptoms?
• When did this first start?
• Have you ever seen blood in your stool?

• What colour?

• Have you ever vomited blood?

• What colour?

Diagnostic Testing

IBS is a diagnosis of exclusion. However the main symptoms have to be present for at least 3 days per month for the last 3 months and presence of at least 2 of the following:

• Symptoms improve with the passing of a bowel movement.
• Onset of symptoms is associated with a change in the frequency of stool.
• Onset of symptoms is associated with a change in the form of the stool.

• Lab Tests that are commonly indicated include: Gastro-Test, Urinary Indican, Urinary lactulose and mannitol levels, Food Allergy Test (IgE) and Food Sensitivity Test (IgG).

Related Symptoms and Conditions

Irritable Bowel Syndrome is associated with a number of other symptoms and conditions including:

• Dysbiosis
• Heartburn
• Asthma
• Lactose intolerance
• Malabsorption
• Hypochlorhydria
• Intestinal hyperpermability
• Inflammatory Bowel Diseases (IBD) such as Crohn's and Ulcerative Colitis.

• One study found that the incidence of IBD was 9x higher in subjects with a previous diagnosis of IBS compared to those without IBS.

• Splenic flexure syndrome

• Gas in the bowel causes pain in lower chest or left shoulder

• Fibromyalgia
• Non-cardiac chest pain
• Chronic Fatigue Syndrome
• Chronic pelvic pain

Characteristics

IBS is a motility disorder that involves both the small and large intestines. With IBS the contractions are either too forceful or not forceful enough. The physiological factors that are associated with IBS include:

• Digestive Flora Imbalance

• Alterations of the microbial population in the gut may be an important factor in the development of IBS. Certain species produce more short-chain fatty acids and gases, which could result in bloating, distention and changes to water and electrolyte transport.,

• Inflammation

• Presence of low grade inflammation in response to altered microbiota may also play a role in the development of this condition by increasing production of certain inflammatory cytokines and effecting levels of other immune system cells.

• Intestinal barrier dysfunction

Common Symptoms

IBS is typically a chronic condition with symptoms that come and go. The symptoms range from mild to severe. The onset of IBS commonly begins in teens years or early adulthood. It is more common in women than in men, 3:1. The presentation of IBS is variable and can include any of the following symptoms:

• Digestive Symptoms

• Abdominal pain and cramping that often begins right after eating.
• Gas and bloating

• Foul-smelling flatulence (gas)

• Constipation

• Difficulty passing stool, fewer bowel movements, straining, cramps

• Diarrhea
• Alternating constipation and diarrhea
• Urgency to have bowel movement which is difficult to control
• Nausea
• Loss of appetite

• Emotional Symptoms

• Anxiety
• Stress
• Depression

• Other Symptoms

• Headaches
• Muscle Pain

• IBS does not predispose a person to [Colorectal Cancer|colon cancer]].

Naturopathic Treatment

The goal of naturopathic treatment is to support and work in tandem with the healing power of the body and to address the causal factors of disease with individual treatment strategies. Irritable Bowel Syndrome is typically considered a chronic disease.

It is always advisable to work with a naturopathic doctor before engaging in any treatment plan.

Home Care

Home Care strategies include:

• Get help developing a stress reduction program and practice it daily.

Lifestyle

Lifestyle recommendations include:

• Dietary recommendations:,

Article	Irritable bowel syndrome: A comprehensive nutrition- based approach, IHP,June/July 2008

• Identify and control food allergies and food intolerances, especially dairy if it is a concern.
• Eliminate the following foods/beverages

• alcohol
• caffeine including coffee and black tea, candy, chocolate
• refined sugar and artificial sweeteners including sugar-free chewing gum
• carbonated beverages
• junk food, fried, processed and spicy foods
• ice cream
• food additives especially mannitol, sorbitol, fructose or lactose
• margarine and pastries
• hydrogenated and partially hydrogenated fats
• any products that contain yeast.

• It is often helpful to eat smaller meals more often and to ensure that your food is properly chewed.
• Consume a [fiber|high-fiber diet]] with a focus on vegetables. Fruit provides fiber, but limit your consumption to one to three pieces a day. Other high-fiber foods include whole grains and legumes, however these must be prepared properly by soaking before cooking, and should be consumed only in small quantities.

• Note: for constipation-predominant IBS, a high-fiber diet might exacerbate symptoms such as bloating.

• Initially you may need to avoid grains until the digestive symptoms subside. When reintroducing grains introduce whole-grain sourdough bread and soak other grains before cooking (brown rice, rolled oats, quinoa, millet, and buckwheat). Unfermented grains are difficult to digest and are particularly irritating to those with IBS. The fermentation process in making sourdough bread breaks down the gluten making the nutrients more available. Always avoid breads made with yeast.
• When having an IBS attack it is best to switch to a bland diet of lightly cooked vegetables. It may be necessary to avoid all raw foods when symptoms are active.
• At the onset of an attack, consider a 24 or 48 hour water fast in order to provide the digestive system with the ability to heal and recover.
• Ensure you drink adequate water.

• Foods that are beneficial include:

• Enzyme-rich fermented foods
• Broth made from chicken and beef bones are particularly healing and nourishing for the intestinal tract.
• Garlic and okra.

• Diets that have found to be helpful include:

• hypoallergenic diet.
• Primitive Diet
• Oligoantigenic Diet

• Exercise

• Physical exercise stimulates intestinal activity and can reduce the symptoms of IBS.
• Take leisurely 20 min walks daily.

• Breathing

• Practice deep breathing exercises. Shallow breathing reduces the oxygen available for proper bowel function.

• Rest and Relaxation exercises such as (deep breathing, meditation, prayer, visualization, etc,) 10 to 15 minutes each day are beneficial.

Naturopathic Therapies

Naturopathic Therapies for IBS include:, ,

• Clinical Nutritional Supplementation includes

• Vitamins such as Vitamin C, Vitamin E
• Amino Acids such as L-Tryptophan.
• Other supplements such as Ground Flax, Acidophilus, Probiotics, Water soluble dietary fibre, 5-HTP, Melatonin.

• Avoid the use of psyllium or bran as these may be irritating to the intestinal lining.

• Herbs such as Chamomile (Matricaria recutita), Lemon Balm (Melissa officinale), Marshmallow root (Althea officinalis), Peppermint (Mentha piperita), Slippery Elm (Ulmus rubra), Thyme (Thymus vulgaris), Boswellia (Boswellia serrata), Bayberry (Myrica cerifera), Comfrey root (Symphytum officinale), Plaintain (Plantago major), Wild yam (Dioscorea villosa),

• Gemmotherapies such as Alnus glutinosa, Ilex aquifolium, Malus sylvestris, Tilia tomentosa

• Homeopathic may be helpful in reducing the frequency of IBS episodes.

• Traditional Chinese Medicine & Acupuncture

• Acupuncture is effective in regulating bowel motility concerns.

References

Reviewed by Iva Lloyd, BScH, RPE, ND [2]