A health condition that has been identified since the end of the 19th century, even today Irritable Bowel Syndrome (IBS) is not fully understood. IBS has gone by many different names, and multiple theories have come and gone regarding its cause and treatment. In the past, and even occasionally now, IBS patients were told that their symptoms were psychosomatic or “all in your head.”
Is this a legitimate physiological disease, or is it a psychological disorder? That is a question that has long been debated. Let’s see if we can form our own opinion.
What is Irritable Bowel Syndrome (IBS)?
Irritable Bowel Syndrome (IBS) is the most common and best researched functional gastrointestinal disorder of the large intestine. It is classified as functional in nature because it is not characterized by any physical or structural defects in the affected organs. IBS has been labeled colitis, mucous colitis, spastic bowel, spastic colon, nervous colon, and functional bowel disorder, to name a few.
IBS is always associated with abdominal pain which may be relieved by defecating, and either constipation or diarrhea, or a combination of constipation and diarrhea. Beyond that, other symptoms vary from person to person. The number of Americans who have suffered from IBS at some point in their lives is estimated at between 10 and 30% of the population. Researchers have come to the conclusion that while stress is a factor with IBS, it is definitely a genuine physical disorder that can be definitively diagnosed.
IBS is most often found in young people under the age of 35. It attacks women twice as often as it does men, and no one is yet sure why. One study determined that IBS was the second leading reason for time missed at work or school. The common cold was first. IBS also accounts for a large percentage of visits to gastrentologists (doctors who specialize in digestive disorders).
Many health practitioners are puzzled by IBS and what causes the health concern. When examined, the bowels of those with IBS don’t display any noticeable irregularities. There is good evidence that stress, anxiety, a poor diet, and carbohydrate malabsorption can all contribute to the health concern. Psychiatric comorbidities such as depression and anxiety can also be a result of functional gastrointestinal disorders like IBS. People with IBS may have a significantly higher tendency for developing anxiety, depression, and psychological distress than people without the disorder.
One theory is that an imbalance in the brain-gut axis may cause irritable bowel syndrome (IBS). The brain-gut axis is the biochemical communication system between the GI tract and the central nervous system. This means that if there is a disturbance in the gut, the issue may not be in the gut itself. The gut could be receiving disrupted signals from the brain.
What Are the Symptoms of IBS?
As stated above, the core symptoms are abdominal pain which may be relieved by a bowel movement, and either constipation or diarrhea or both. These are the ones that define the syndrome. In 1988, physicians at the International Congress of Gastroenterology drew up a set of criteria called “The Rome Criteria” that are the standards for diagnosing IBS. Basically, without going into a lot of detail, certain of these core symptoms, along with other common symptoms, must be observed for at least 90 days in order to nail down a diagnosis of IBS. Below are some of the other symptoms that are often experienced, but keep in mind that these vary from case to case:
- Bloated feeling
- Acid Reflux
- Feeling full even after a very small meal
- Abdominal pain or swelling
- Sticky fluid (mucous) passed with bowel movements
- Feeling like one still has to “go” even after a recent bowel movement
- Urgency to defecate
- Weakness or fatigue
- Trouble sleeping
- Varying degrees of depression or anxiety
- Muscle aches in lower back
Some researchers have broken down IBS cases by degrees of symptoms: 70% are considered “mild”, 25% are “moderate,” and the remaining 5% “severe.” Patients with mild IBS have minimal symptoms that are not constant. Their normal daily activities are not disrupted. Moderate IBS cases experience some disruption of daily activities, as well as some psychological problems. Severe cases are not able function normally on a daily basis. They may experience intense and constant pain, as well as significant psychological difficulties.
What Are the Causes of IBS?
There are several likely causes for IBS. This illness is still not completely understood, but as more quality research is done, better conclusions are being made.
Stress has definitely been identified as a factor, both physical and emotional. Studies have determined there is a connection between the nervous system and the intestines in all of us, IBS patients or not. All of us have had “butterflies in our stomach” during stressful moments. People with IBS seem to react more intensely to stress than folks without IBS, at least as it manifests itself in gastrointestinal symptoms. It has also been determined that IBS sufferers experience a change in the way the colon functions when they are under stress. Normally, a process called peristalsis occurs whereby the muscles of the colon contract in a wave-like motion to move food along the pathway. When IBS patients are under stress, the motility of the colon is increased, meaning the normal patterns of contractions are sped up. This leads to abdominal pain and diarrhea. Several years ago, a study was done through Johns Hopkins University that compared colon contractions of healthy people to those with IBS. It was found that the healthy subjects averaged six to eight contractions per day. IBS patients with diarrhea averaged about 25 per day. Constipated IBS patients had next to none. Another interesting discovery was that many of the IBS subjects reported stronger than normal contractions. It was described by one of the researchers as “like having a charlie horse in the gut.”
A second major cause for IBS is thought to be a diet that is high in refined sugar. When a lot of refined sugar is consumed, it spikes the blood sugar. When this happens in IBS patients, the colon’s motility is decreased, or in some cases stops altogether. This has the opposite effect of stress, and causes constipation. Researchers believe a diet high in refined sugar is the main reason IBS is so common in the United States.
Food allergies have long been suspected as culprits in IBS. Research has been done regarding this factor since the early 1900’s. Studies now show that about 66% of those with IBS have at least one food allergy. Dairy is the most common one, followed by many types of grains. Some IBS patients have more than one food allergy. It is still not known exactly how these allergies affect IBS, but food allergies are definitely a common thread.
Some people believe that a fungus, candida, may be to blame for IBS. The real mystery is why it’s not usually recognized as a trigger for IBS. What we do know is if you have Irritable Bowel Syndrome ((IBS), candida yeast can make your symptoms much worse. There is one review which specifically addresses the issue of IBS and Candida. The researchers indicate that there is some evidence that yeasts can contribute to IBS symptoms in a certain sub-class of individuals – individuals who have systems that are sensitive to the effects of candida (this actually could be thousands of people). They discuss several theories as to why this might be:
- 1. Candida acts to stimulate mast cells, leading them to release substances that contribute to inflammation within the intestines.
- 2. Candida produces “proteases”, substances that can interfere with the function of immunoglobin. This “Ig” effect can also contribute to gut inflammation.
Unfortunately, more research is needed before conventional medicine will recommend antifungal treatment as a first line treatment for IBS. Personally, I believe they may be refusing to look at a definite cause of IBS.
A lack of fiber in the diet is also a contributing factor with IBS. Fiber is extremely important to a healthy digestive tract. Proper bowel movements cannot be had without it. Most IBS patients need more fruits and vegetables in their diet to provide quality fiber. This seems to work better than cereal forms of fiber for individuals with IBS.
Did You Know? Health Conditions Similar to IBS
Many other health conditions produce the same or similar symptoms as IBS. These health conditions could include:
- Colorectal cancer
- Bacterial infections
- Intestinal parasites
- Food poisoning
- Food allergies
- Menstrual pain
- Crohn’s disease
- Bowel blockages
- Small bowel bacterial overgrowth (SIBO)
- Yeast overgrowth
- Leaky gut
This is not a complete list; there are many more potential causes of IBS symptoms, as mentioned above. Some of these conditions are serious. Please speak with your healthcare professional and don’t self-diagnose.
Natural Remedies for IBS
IBS is another illness of our modern time that many consider to be a curse of affluence. The best way to combat IBS is to try and lower the stress in our lives, and eat a diet composed of real food, not the processed mush that passes for food. Fortunately, there are some simple, natural lifestyle changes that can help reduce IBS occurrences.
Eat a Healthy Diet
A healthy diet is critical to managing IBS. Instead of three large meals each day, try eating 4-5 smaller meals. Lots of fiber from fruits and vegetables should be coupled with liberal amounts of clean, pure water every day. Along with this, be sure to avoid refined sugar and foods or beverages such as alcohol, coffee and other caffeinated drinks, foods high in saturated fats, and spicy foods. If you suspect a food allergy, try some experimentation with eliminating foods one by one and discovering the allergen(s) by the process of elimination. Some people find that eliminating gluten from their diet is very effective in treating irritable bowel syndrome.
Becoming physically and emotionally tense, angry, or overwhelmed can cause colon spasms in those with IBS. Your colon contains a vast supply of nerves that connect it to the brain. These nerves control the normal rhythmic contractions of the colon and can cause abdominal discomfort at stressful times. People often experience cramps or “butterflies” when they are nervous or upset. But with IBS, the colon can be overly responsive to even slight conflict or stress. Stress is an issue that can be dealt with in many creative ways such as a gentle massage before bed. This will make for better sleep too which also reduces stress and strengthens all the body’s systems. Some people like to relax via a warm bath. Practicing meditation and/or yoga can also help with stress issues. Whatever works best for you. Just try to be consistent.
Daily Exercise has many different faces, so pick the one that looks most friendly to you and go for it. Regular exercise does so many good things for the body. Not only will it help IBS by relieving stress, it will also help your digestive system work more smoothly. In 2011, researchers reported in the American Journal of Gastroenterology that study participants who were physically active had noticeably improved GI symptoms compared to the participants who did not exercise.
Practicing mindful breathing a few minutes a day may have lasting beneficial effects on a number of conditions including irritable bowel syndrome as well as anxiety and depression. When you practice mindful breathing you gain a helpful skill to use whenever you need to quiet and clear your mind. Deep and slow breathing stimulates the vagus nerve. This nerve connects the brain stem with the abdomen, and it is part of the parasympathetic nervous system. This system is responsible for so-called “rest and digest” activities. For example, it causes the heart rate to decline when we exhale.
Drink More Purified Water
Your digestive tract will have a laborious time if waste is a hard and dry, so be sure to stay properly hydrated. Hydration is very important. In fact, most people stay slightly dehydrated. Drinking enough purified water every day isn’t just necessary to prevent constipation — hydration is just as important for those that often experience diarrhea, even more so. Because of water-loss with every bowel movement, the risk of dehydration is much greater. Drinking eight glasses a day of purified water is a good start, but even better is to drink half your weight in ounces of purified water every day. Dehydrating liquids, such as coffee, soft drinks, and alcohol are not recommended.
Your gut houses beneficial microorganisms which make up your microbiota. A microbiota that is healthy has an intensely positive effect on your gut health. Eat probiotic foods such as kimchi, sauerkraut, and kombucha or taking a probiotic supplement to maintain healthy gut flora. According to research, a bacterial species called Bifidobacterium infantis is very effective at improving the symptoms of IBS. I recommend using a high quality probiotic and prebiotic formula such as Floratrex which can help restore the balance of flora in your gut. Friendly bacteria are necessary for effective digestive tract function.
Check Vitamin D Levels
A 2018 study published in the European Journal of Clinical Nutrition showed a high prevalence of vitamin D deficiency in IBS patients, regardless of ethnicity. The study also states that vitamin D might be helpful in easing painful symptoms linked to irritable bowel syndrome. The University of Sheffield’s Department of Oncology and Metabolism, and molecular gastroenterology research group under the guidance of Bernard M. Corfe, MD integrated and analyzed available research data from previous studies concerning the relationship between vitamin D levels and irritable bowel syndrome.
An extensive analysis was conducted in three randomized controlled trials and four observational studies. The research found that vitamin D could reduce painful symptoms such as diarrhea, bloating, and constipation often associated with IBS. Researchers also observed that, in women, a high dose of daily vitamin D significantly improved IBS symptoms. This suggests promising evidence that vitamin D and IBS are interlinked.
Despite limited evidence, the present findings are enough to suggest that taking vitamin D may very well improve IBS symptoms. Scientists noted that there is a need for further research in this area. However, those with IBS should consider, at the very least, getting their vitamin D levels tested.
Your body’s ability to make enzymes starts to decline at around age 20. Around the age of 40, enzyme production drops about 25 percent from when you were younger. In fact, by the age of 70, you could be producing as little as a third of the enzymes you need. A leaky, damaged or inflamed digestive tract can also cause an enzyme deficiency. When the lining of the digestive tract wall becomes irritated or damaged (glyphosate is a powerful gut destroyer), your body’s production of enzymes can be strongly affected. It’s good to remember that every cell in your body requires enzymes to function. While current scientific data on the use of digestive enzymes for IBS is not conclusive, researchers have detected promising connections. One study found that when individuals who frequently suffered from diarrhea after meals took an enzyme mixture containing a commercial mixture of amylase, lipase, and protease before eating, they reported a reduction in their symptoms. Another study found that when people with IBS took a combination of digestive enzymes and soluble fibers, they noticed a significant reduction in stomach discomfort, gas, and bloating. If you decide to supplement with a digestive enzyme formula, it should be broad based, providing a wide variety of enzymatic activity. A small array of different enzyme types does not always do the best job. A wide ranch of different types of enzymes in a formula is required to break down a broad variety of foods. I highly recommend Veganzyme which is a broad based blend of the most powerful digestive and systemic enzymes that support digestion, boost the immune system, and encourage functional balance throughout the entire body.
L-glutamine, one of the body’s most prevalent amino acids and known as the calming amino acid, has an excellent track record of helping people beat sugar addiction. Just a reminder that a diet high in refined sugar is a definite cause of IBS. The best part is that one does not have to supplement with L-glutamine forever – just until the cravings pass. Daily add 500 milligrams three times a day between meals and an extra dose when a craving hits (it’s a good idea to work up to this level in small increments). Other health benefits of L-glutamine can include healing stomach ulcers, stopping diarrhea and repairing “leaky gut”. Glutamine is the only amino acid containing two amine groups. This enables glutamine to give up one of these amine groups to combine with glucose to make: n-acetyl-glucosamine which is essential for repairing the intestinal lining; and acetyl-d-glucosamine—responsible for healing cartilage, tendons, and ligaments. This same property makes it the primary energy fuel for the small intestine and therefore increases immune function of the stomach.
Your colon is one of five elimination routes (four for men) that your body uses for the elimination of waste products and toxins. A blocked or sluggish colon can cause waste products to accumulate in your gut which can eventually compromise your health. When combined with a healthy diet, hydration, and exercise and stress elimination, colon cleansing can gently detoxify your digestive tract and normalize bowel function.
Herbal Options That Show Promise for Managing IBS
- Peppermint oil extract is excellent for soothing the bowels. Use a supplement packaged in enteric-coated capsules. This causes the peppermint to be released in the intestines where it can be of benefit, rather than in the stomach.
- Artichoke extract is great for many symptoms including bloating, nausea, constipation, and abdominal pain. Also works well as an appetite stimulant.
- The following herbs are known for being soothing to the digestive tract:
- Comfrey root: also called “knit bone”. Used for stomach ulcers and diarrhea.
- Oats: soothes the nerves, used also for depression
- Quince seed
- Marsh mallow root
- Slippery Elm
- Iceland moss
- Irish moss
- A group of herbs known collectively as “carminatives” have a history of helping to relieve excess gas:
- German chamomile
- Certain herbs can help to stabilize bowel function:
- Meadowsweet is great for diarrhea.
- Herbs with a laxative effect include: barberry, dandelion root, licorice, psyllium ovata seed, and yellow dock.
- Cramps can be relieved with the help of these antispasmodic herbs:
- German chamomile
- Lemon balm
IBS is not a life-threatening disease in itself, nor is it thought to lead to other bowel conditions or cancer. It certainly is not at the top of the list for diseases that are heavily funded for research, and it probably does not deserve to have that kind of priority. For many, it is merely an inconvenience. However, for some people, IBS can be very disruptive to their daily lives. Perhaps the best that can be said about IBS is that if we apply the healthy diet and lifestyle changes recommenced in this article, not only will our IBS condition improve, but we will also be on the right track for overall good health and wellness. Let’s keep our eye on the prize!
REFERENCES and RESEARCH
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“Conditions with Similar Symptoms As Irritable Bowel Syndrome.” University of Maryland Medical Center. University of Maryland, 8 Nov. 2005. Web. 17 July 2017.
Elli L, Tomba C, Branchi F, et al. Evidence for the presence of non-celiac gluten sensitivity in patients with functional gastrointestinal symptoms: results from a multicenter randomized double-blind placebo-controlled gluten challenge. Nutrients. 2016;8(2):84. doi:10.3390/nu8020084.
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Brenner, Darren M., Matthew J. Moeller, William D. Chey, and Philip S. Schoenfeld. “The Utility of Probiotics in the Treatment of Irritable Bowel Syndrome: A Systematic Review.” The American Journal of Gastroenterology 104.4 (2009): 1033-049. Web. 17 July 2017.
European Journal of Clinical Nutrition 2018, DOI: 10.1038/s41430-017-0064-z
University of Sheffield January 25, 2018
Greg Feldman, Jeff Greeson, and Joanna Senville. Differential effects of mindful breathing, progressive muscle relaxation, and loving kindness meditation on decentering and negative reactions to repetitive thoughts. Behav Res Ther. 2010 Oct; 48(10): 1002–1011. Published online 2010 Jun 23. doi: 10.1016/j.brat.2010.06.006
Gianluca Ianiro,et al. “Digestive Enzyme Supplementation in Gastrointestinal Diseases.” Curr Drug Metab. 2016; 17(2), 187–193. Accessed Oct 11 2018.
Ismail FW, Abid S, Awan S, Lubna F. Frequency of food hypersensitivity in patients with functional gastrointestinal disorders. Acta Gastroenterol Belg. 2018;81(2):253-256.