The Management of Irritable Bowel Syndrome (IBS)

Irritable Bowel Syndrome – IBS

 IBSIBS is thought to affect as many as one in five people at some time in their lives and women are twice as likely to suffer as men. IBS can affect all age groups from the infant who cries with colic to the elderly. It can range in severity from a temporary interruption in the otherwise normal life, to a condition which is extremely debilitating. Those who suffer from it find it dominates their lives and can wreak havoc with work and social commitments.

Irritable bowel syndrome (“spastic colon”) is characterised by abdominal cramping, change in bowel habits, excess mucous secretion in stools, indigestion and heartburn, bloating, flatulence, diarrhoea or constipation, temporary pain relief after passing stools and is often accompanied by fatigue, depression and anxiety. It is poorly understood, but it appears that several interacting factors contribute to the development of IBS.

These can include one or more of the following:

  • Poor digestion
  • imbalanced gut flora
  • yeast or parasite infection
  • bowel inflammation and leaky gut
  • food intolerance or  hypersensitivity
  • disturbed gastro-intestinal motility
  • low fibre diet. The popularity of highly processed, fast convenience foods ensure that many people’s diets are fibre deficient. Fibre is necessary to increase motility and help cleanse the colon.
  • laxative and antibiotic abuse –  these tend to upset the balance of gut flora, killing off the good flora and leaving the defences down for the overgrowth of bacteria, parasites and other organisms.
  • psychological factors such as  stress, anxiety, depression or anger. These factors are not a primary cause of IBS but can make the symptoms worse.
  • dietary factors such as dairy products, excess fats, coffee, alcohol, processed foods

Some people find that symptoms are triggered by particular foods (e.g. wheat, chocolate, dairy products). IBS may be caused by food sensitivities – regular ingestion of an allergen can cause chronic inflammation of the bowel and swelling of the abdomen, with attempts by the bowel to expel its contents as quickly as possible. This can result in griping pains and diarrhoea. The strength of the response is often related to the calorific density of the meal and especially the amount of fat in a meal which is a strong stimulus of colonic contractions.

Leaky gut syndrome can occur when the gut walls become inflamed and can no longer provide an effective barrier to stop partially digested food elements entering the blood stream. The immune system goes on the attack and an allergic reaction is the result, causing future food intolerances. A leaky gut also means that nutrients are not absorbed properly which can then lead to bloating, flatulence and cramping.

A healthy diet, including plenty of fibre and fluids is recommended. Eating plenty of fresh fruit and vegetables will increase dietary fibre. Fibre encourages the growth of friendly bacteria in the colon which are essential in maintaining the health of the colon. Drink plenty of water (at least 1 – 2 litres daily). Alcohol, coffee, strong spices and food additives which stimulate excessive contraction of the bowel muscles should be avoided. IBS may be helped by avoidance of specific foods which may be causing an allergic response.

Gentle exercises (such as curl-ups) help to strengthen abdominal muscles and promote normal intestinal contractions.

In severe cases a more targeted clinical program is required. There are generally four stages in such a program. First you need to remove any pathogens, fungi, parasites or other toxic elements. Also you need to exclude any foods to which you are intolerant or allergic. Then you need to replace enzymes and other digestive factors which might be lacking. Probiotics need to be taken to re-introduce healthy gut flora. Finally you need to repair and heal the gut lining by using various nutrients and supplements. This generally needs to be carried under the supervison of a nutritional therapist.

Addition of certain nutritional supplements can help to alleviate some of the symptoms of IBS. Taking soluble fibre supplements such as psyllium husk will help those people who find constipation a problem. Apple Pectin and charcoal may also be helpful for those with sluggish bowels. These help to absorb more water making the faeces softer and so easier to pass without straining.

People with poor digestion may well benefit from taking digestive enzymes which can improve the digestive process and thus prevent the passage of undigested food through the gastrointestinal tract which may cause some IBS symptoms. A supplement containing the following enzymes may help:

Amylase – helps digest carbohydrates
Protease – helps digest protein
Sucrase – helps digest sugar
Lactase – helps digest milk sugar
Maltase – helps digest malt sugar
Cellulase – helps digest fibre

Betaine hydrochloride may be a useful supplement as this helps production of hydrochloric acid in the stomach which stimulates the pancreas to secrete digestive enzymes. These help with protein and fat digestion. However, people who have stomach ulcers or who suffer from gastritis should avoid protease and betaine hydrochloride.

Papaya extract contains a unique enzyme called papain which is an important protein digesting enzyme which stimulates digestion and bowel movements. It is frequently used in the treatment of IBS type symptoms.

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