Irritable Bowel Syndrome – Detailed Info



20% of the world population is estimated to suffer from Irritable bowel syndrome (IBS) which is characterised by abdominal pain and an irregular bowel habit. In fact, as many as half the people who visit a doctor complaining of digestive problems probably have irritable bowel syndrome.
IBS often results from a combination of physical and stress-related factors. The brain and the gut's nervous system are intertwined through a series of hormones and biochemicals, which means that negative thoughts can have profound effects on digestive function.  Changes to diet and lifestyle, stress management or other psychological therapy should be a major part of your treatment plan.
IBS does not lead to more serious conditions, such as cancer or inflammatory bowel. However, the condition can have a devastating impact on your happiness, your relationships and even your career.


Three Types of IBS
IBS-C (IBS with constipation predominant): When signals are sent less often, contractions are less frequent, and often cause constipation.
IBS-D (IBS with diarrhea predominant): When signals are sent more often, contractions are more frequent, and often cause diarrhea.
IBS-A (IBS with alternating stool pattern): When signals are sent sporadically, contractions are inconsistent, and often cause bouts of both diarrhea and constipation.

IBS symptoms:
Diarrhea or constipation, or alternate bouts of each
Urge to have another bowel movement after you've just had one
Abdominal pain or cramping
Gas, bloating & nausea, especially after eating
Depression, anxiety & fatigue
The symptoms mimic those of more serious gastrointestinal, hormonal, and reproductive diseases and vary not only from person to person but in the same person from week to week.

Aggravators:
Feelings of nervousness, anxiety, guilt, depression, frustration, or anger may bring on or aggravate this very common disorder.
Alcohol / Cigarettes / Caffeine / Citrus fruits / Gas producing foods / Spicy foods / Wheat Intolerance / Fructose intolerance / Lactose intolerant (Yogurt and hard cheeses don't seem to cause any symptoms because their bacterial content converts much of the lactose to lactic acid before they're consumed.)
Artificial sweeteners Sorbitol or Xylitol are not digestible.
Fatty meats, butter, and oils are more difficult for the body to digest.
Overusing laxatives that contain stimulants can harm your intestines. Magnesium-based laxatives are relatively safe to use (except by those with kidney problems).

Anyone with IBS should automatically avoid refined sugar, refined flour (white, bleached), hydrogenated fats, acidic, tomato-based foods like spaghetti sauce and pizza, processed foods, luncheon meats or hot dogs, and foods with artificial flavor/color, preservatives or msg.

Counselling
·         Confront and understand your fears and concerns.
·         Perfectionists who are unwilling to compromise and people who see the world in black and white instead of shades of gray can have a negative effect on the digestive system.
·         Take a deep breath when stressed and try to maintain a smile even when in bad moods. Picture a stress-free surroundings and relaxing is greatly helpful.
·         Stress management techniques like meditation, deep breathing, yoga and even hypnosis can all improve IBS.

Exercise  
·         Activity helps the digestive system work properly.
·         Exercise can also aid IBS sufferers by distracting them from their symptoms and by promoting the release of endorphins, the body's feel-good hormones.
·         Note - Strenuous workouts may cause diarrhea.

Eating Habits & Digestion Tips
·         You're more likely to swallow air when you gobble down your food, which can cause intestinal gas.
·         Chewing food properly helps secrete digestive enzymes and breaks down the food in small particles.
·         Eat on Time
·         Eat several smaller meals. Large meals can overload the digestive system.
·         Drinking when you eat dilutes digestive juices and frustrates digestion. Drink liquids between meals instead of with them.
·         Eat your final big meal at least three hours before bedtime. You don’t digest very well when sleeping.
·         Sometimes sipping a plain old cup of hot water eases indigestion.
·         One teaspoon of apple cider vinegar mixed with a half-cup of water.
·         Stir a teaspoon of baking soda into a glass of water and drink it. This solution neutralizes stomach acid and helps relieve gas and bloating.
·         Beware of juice and dairy

Therapeutics
·         A hot bath may relieve stomach cramping.
·         Apply hot compresses or a heating pad to your abdomen.
·         There are strong link between acupuncture and the relief of IBS symptoms
·         Gently massage your esophageal valve by rubbing gently just under your solar plexus and stroking downwards toward your belly button.
·         When you go to sleep, lie on your left side. Your stomach opens up to your left and this encourages the food and acids to stay in your stomach and away from your esophageal valve.

Helpful Diet
Fiber - Increasing fiber is a cure for almost every intestinal ill. Insoluble fibre such as bran is not beneficial; only isphaghula husk - a soluble form of fibre - significantly reduced symptoms.
Water - Drinking six to eight glasses of water a day is important, especially if you have diarrhea or are increase your fiber intake.
Cabbage - It soothes the symptoms of intestinal ills. Cook the cabbage in a very small amount of water until very mushy. Then pulverize with a fork or mixer.
Carrots / Lettuce / Pears / Fennel seeds / Flaxseed / Ginger / Yogurt & Other Probiotics / Fermented Foods - They help improve digestion and relieve IBS symptoms.

IMPORTANT
If there is a dysfunction of the autonomic nervous system, then some of the symptoms seen in IBS and IBD present themselves. Furthermore, dysfunction of the autonomic nervous system affects the endocrine system and vice versa. If a patient is highly stressed they will have a high alpha sympathetic activity, which may cause contraction of the digestive sphincters, leading to constipation. If a patient presents with an increase in mucus secretions, diarrhoea and spasm, then parasympathetic activity may be high. Regulation of the autonomic nervous system can bring about relief of symptoms, but involves a deeper level of treatment to those mentioned earlier.

Some examples of herbs that can affect the autonomic nervous system are:
Herbs that decrease parasympathetic activity:
  • ·         Chamomile
  • ·         Thyme

Herbs that decrease alpha sympathetic activity:
  • ·         Lavender
  • ·         Lemon balm

Herbs that increase beta sympathetic activity:
  • ·         Blackcurrant bud
  • ·         Licorice root


On the deepest level of treatment, one must look at the endocrine system, which is the global manager of the body. Insufficient thyroid activity can results in an increase in TSH (Thyroid Stimulating Hormone) to the demand created by FSH (Follicle Stimulating Hormone). This causes a compensatory metabolic shift away from glucides to lipids. As a result, there is a disturbance in liver function, which causes a change in the intestinal micro flora causing dysbiosis and thus, chronic inflammation. The complex nature of the agents that cause disease are perfectly matched by the complex nature of plant medicines.
Some examples of herbs that can affect the endocrine system and decrease FSH levels:
  • ·         Gromwell
  • ·         Borage
  • ·         Herbs that improve thyroid function:
  • ·         Oat seed
  • ·         Bladderwrack



In some cases the adrenal gland (a gland situated above the kidneys which produces cortisol) may not be functioning efficiently due to underlying hormonal imbalances or chronic stress, from the disease itself. In such cases licorice root and blackcurrant bud are vital in supporting and restoring proper function to the adrenal glands.

Often, the pancreas, liver and gallbladder can become congested, and the proper drainage of these organs can be of great value. Many of the herbs used  include agrimony, fumitory, burdock root, green walnut leaf, wormwood, dandelion root and globe artichoke.

Constipation
The easiest remedy for constipation is simply to increase your intake of vitamin C (in ascorbic acid form) and magnesium. About 40% of Americans are deficient in magnesium so this is a mineral you probably will only benefit from - the only side-effect of magnesium is diarrhea. A deficiency of this essential mineral can cause interference in the transmission of nerve and muscle impulses, causing irritability and nervousness. Along with the symptoms of IBS, a deficiency can show up as insomnia, irritability, poor digestion, rapid heartbeat, and seizures. Some nutritionists and holistic doctors also say that a deficiency is the root cause of many cardiovascular problems. Start at 2000 mg vitamin C and 200 mg magnesium per day.
Caution: do not confuse this supplement with the laxative Milk of Magnesia. Milk of Magnesia contains a completely different form of the supplement called magnesium hydroxide, which is specifically intended to be used as a laxative.
Triphala Churan – It is an herbal preparation that combines the fruit of the bibhataki and haritaki trees, along with that of the amalaki tree. In addition to its laxative effect, triphala is thought to reduce abdominal pain and bloating.

Diarrhea
L-Glutamine (amino acid) directly nourishes and heals the mucosal lining of the intestine and causes the bowel to reabsorb the water in your stool, thus reducing the number and frequency of bowel movements. Do not use if you have any liver or kidney disease.
DGL (deglycyrrizinated licorice) sold in health-food stores coats the lining of the stomach, reducing ingestion and stomach upset.
AMP (Aloe Mucilaginous Polysaccharide) is an isolated and concentrated healing agent from the Aloe Plant. The mucopolysaccharides in AMP aide in improving the function of the immune system. However, the laxative component (called aloin) of the aloe plant has been removed.
Chamomile - It reduce inflammation and quiet spasms in the gut.
Berry Leaf Teas - Blueberry, blackberry and raspberry leaves contain substances called tannins, whose effect on reducing inflammation and decreasing secretion of fluid may account for the anti-diarrheal reputations of these teas.
Peppermint - It relaxes your intestines, reduces spasms, and relieves gas pain. You can take enteric-coated peppermint-oil capsules. The coating ensures that the oil reaches the intestine instead of breaking down in the stomach. Take one capsules between meals.
Hyoscine - Extracted from the cork wood tree is the most successful antispasmodic drug.
Slippery Elm - It is thought to calm irritation by coating the lining of the intestinal system. Slippery elm’s effect on the stool illustrates why it is seen as helpful regardless of one’s predominant IBS symptom.
Astringents, used in the treatment of diarrhoea, work by tightening the mucous membrane of the intestines thus reducing secretion and excretion. Such herbs include agrimony and sage.
In addition to astringents and anti-spasmodics, anti-inflammatories are crucial in dealing with the chronic inflammation that occurs. One such herbal anti-inflammatory is licorice root.
Frankincense is another herb that shows promising results in the treatment chronic inflammatory diseases, including Crohn’s disease and ulcerative colitis.
Golden seal and Ground ivy are Mucus membrane trophorestoratives, which are an important group of herbs which help to restore the integrity of the mucus membrane of the intestines, thus preventing antigens from penetrating it and causing inflammation. Golden seal has the added benefit of being anti-microbial and haemostatic, so is useful in the treatment of gastric infections and blood loss.

Digestive Enzymes
Amylase – breaks down starch into sugar
Protease – one of many enzymes that help break down protein
Lipase – breaks down fats
Lactase – breaks down lactose (found in dairy products)
Cellulase – aids in the digestion of fiber from fruits and vegetables
Bromelain – found in pineapple, it helps break down protein
Pepsin – helps break down protein
Papain – found in papaya, it helps break down protein
Alpha Galactosidase – the main ingredient in Beano, breaks down those gassy complex carbohydrates, like beans, fresh vegetables and whole grain bread.

The right amount of hydrochloric acid (HCL), digestive enzymes, which are secreted from the pancreas and bile, are essential for proper breakdown and emulsification of foods. This ensures that undigested foods that can potentially irritate the intestines further along the digestive tract and cause inflammation get properly broken down. 

IBS Symptom Journal
Symptom 1 Symptom 2 Symptom 3
Date/Time Symptoms Began and Ended
Description of Symptoms (pain, bloating, diarrhea, constipation, etc.)
Where Symptoms Began
Pre-Symptom Activity
Type of Food Eaten
Amount of Food Eaten (Rate 1-10 with 10 as an excessive portion.)

Medications Taken
Suspected Trigger(s)