Irritable Bowel Syndrome

Irritable Bowel Syndrome (IBS)  is characterised by chronic abdominal discomfort, cramps or pain, bloating, gas, diarrhoea and constipation. It is a diagnosis based on symptoms and exclusion of other conditions. Sometimes it can also be called Spastic colon. Usually it develops between the age of 20-30 yrs, and affects twice as many women as men. IBS is considered to be a functional disorder with no organic cause. Risk factors include, low-fiber diet, emotional stress, use of laxatives, repeated bouts of infectious diarrhoea or other diseases involving bowel inflammation.

Symptoms of IBS

Symptoms can vary between individuals, affecting some people more than others. There is a tendency for individuals to either have a diarrhoea-predominant IBS, or a constipation-predominant IBS. However, some people can have alternating bouts of constipation and diarrheoa. Fortunately, unlike some other diseases the symptoms do not cause permanent damage to the colon and therefore does not affect life expectancy. Other associated symptoms can include; cramps, bloating, gas, urgency to move bowels, mucus in stool, fatigue, headaches, anxiety, depression and complications due to infections. Up to 60% of people with IBS may have anxiety or depression. Stress is a well known to triggers IBS symptoms.There is a considerable effect on quality of life, with a high social cost and a cause of days off work.

 

Treatment of IBS

The treatment aim is symptoms relief. For some changing their diet will reduce symptoms. Increasing fiber whilst avoiding stimulants e.g. tea, coffee or sugary drinks, and regular exercise may also help. Conventional drug therapy includes the use of;

  • Antispasmodic muscle relaxants to help relax intestinal muscles and relieve pain.
  • Laxatives to help with constipation.
  • Antidiarrhoeals to relieve diarrhoea.
  • Antidepressants ( in low-dose) to reduce stomach cramps, but may also help with depression.

Integrative & Complementary medicine

Acupuncture may help to provide pain relief, regulate the movement of the digestive tract, reducing the sensitivity of the gut (to problem foods), enhance relaxation to counteract stress, reduce anxiety and depression which is a contributor to triggering IBS. Overall, acupuncture promotes general well being. It can be safely used alongside conventional medication.   

Nutrition: While many will find that dietary changes and recognising food intolerances is beneficial, although there is insufficient evidence to recommend strict restrictive diets1. Management of diet, stress and lifestyle will in many cases offer a greater control over the condition. Avoiding problem foods (e.g. alcohol, chocolate, caffeinated beverages, sugar substitutes and fatty foods), or food allergies, eating smaller meals and drinking plenty of fluids whilst avoiding dehydrating drinks is a necessary step. Avoid refined and processed food. Reduce intake of red meat. Incorporating dietary fibre can benefit some people as it can improve diarrhoea or constipation.

Gut dysbiosis is also a factor for IBS, (i.e. negative imbalance between good and bad bacteria in the gut).  Literature suggests that in IBS there a lack of sufficient ‘good bacteria’ in the gut as well as microscopic inflammation1,2. These bacteria have an important role in the digestive and absorption process allowing us to eat a wide range of foods. However the western diet and lifestyle choices negatively affect the gut balance leading to poor digestion and damage to the gut environment. Probiotics2 will help to restore the digestive environment and psyllium to increase dietary fibre.

Aromatherapy & Massage: Antispasmodic essential oils e.g. black pepper, sweet fennel, peppermint and Roman chamomile, and sedative and relaxing oils e.g. lavender, neroli, frankinscence and mandarin to relieve stress and depression can be useful. Chamomile herbal tea can be soothing to the digestive system. Massage will help to de-stress and improve general well being.

Other therapies: Stress reduction techniques, hypnosis, biofeedback, yoga, meditation and relaxation techniques may also alleviate symptoms1.

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References:
  1. Ducrotté, P. ( 2007). “[Irritable bowel syndrome: current treatment options]“. Presse Med 36 (11 Pt 2): 1619–26. [Weblink]
  2. Aragon G, Graham DB, Borum M, Doman DB. (2010). Probiotic therapy for irritable bowel syndrome. Gastroenterol Hepatol (N Y). 6(1):39-44. [Weblink]

 

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Reviewed: Dec 2014

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