Irritable Bowel Syndrome

By Dr. Loretta Lanphier, ND, CN, HHP, CH

Irritable Bowel Syndrome is a condition that has been identified since the end of the 19th century, and yet even today it is not fully understood. It 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, patients were told that the 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?

Irritable Bowel Syndrome (IBS) is a functional 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).

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:

  1. Flatulence
  2. Nausea
  3. Cramps
  4. Bloated feeling
  5. Feeling full even after a very small meal
  6. Sticky fluid (mucous) passed with bowel movements
  7. Feeling like one still has to “go” even after a recent bowel movement
  8. Urgency to defecate
  9. Varying degrees of depression or anxiety

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.
  • 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.

How Can I Prevent or Treat the Symptoms of IBS?

IBS is another illness of our modern time that I 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 so often in our American gullets. Maybe if we slowed down and took the time to prepare wholesome quality food, we would find that our grocery stores packed with endless options of fast, nutritionally empty stuff, devoid of fiber and loaded with sugar, are not as wonderful as we might think.

Diet is critical to managing IBS. 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.

Stress is another issue that can be dealt with in many creative ways. 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. Stress can also be aided by a gentle massage before bed. This will make for better sleep too which also reduces stress and strengthens all the body’s systems. Some folks like to relax via a warm bath. Whatever works best for you. Just try to be consistent.

There are many herbal options available that have shown some 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.
  • A quality probiotic formula is highly recommended. This will help restore the balance of flora in the gut. Friendly bacteria are necessary for good digestive tract function.
  • 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:
    1. Comfrey root: also called “knit bone”. Used for stomach ulcers and diarrhea.
    2. Hops
    3. Oats: soothes the nerves, used also for depression
    4. Quince seed
    5. Marsh mallow root
    6. Slippery Elm
    7. Iceland moss
    8. Irish moss
  • A group of herbs known collectively as “carminatives” have a history of helping to relieve excess gas:
    1. Peppermint
    2. Thyme
    3. Caraway
    4. Cayenne
    5. German chamomile
    6. Ginger
    7. Angelica
    8. Aniseed
  • Certain herbs can help to stabilize bowel function:
    1. Meadowsweet is great for diarrhea.
    2. Herbs with a laxative effect include: barberry, dandelion root, licorice, psyllium ovata seed, and yellow dock.
    3. Cascara, buckthorn, and rhubarb root are laxatives as well, but these must be used carefully, as they have more intense properties.
  • Cramps can be relieved with the help of these antispasmodic herbs:
    1. German chamomile
    2. Ginger
    3. Valerian
    4. Lemon balm
    5. Wild yam

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 folks, 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 wellness. Wellness, or absence of disease, is the ultimate goal. Let’s keep our eye on the prize!

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