Have Irritable Bowel Syndrome (IBS)? Kimsey to the rescue!

In the first part of a two-article series, Master Nutrition Therapist Kimsey Self describes how you can know if you have IBS or if you’re likely to suffer from it.

Irritable Bowel Syndrome (IBS) affects approximately 10-15 percent of the population, and that only includes the 25% of sufferers that actually see a physician for it. It has become a “catch all” for bowel complaints in which other pathological bowel conditions have been ruled out. IBS is characterized by constipation and/or diarrhea, gas, bloating, fatigue, abdominal cramps, abdominal distention, pain relieved by having a bowel movement, and sometimes accessory symptoms such as sleep disturbances, headaches and backaches. Though it affects millions of Americans, there is still no exact known cause.

Patients have even been told by their doctors that their symptoms are psychosomatic, which is a fancy way of saying “you’re imagining it.” Patients may be told to eat more fiber, typically from whole grains, and are dismissed. In reality, there are numerous causes for IBS, with food sensitivities (especially gluten and dairy), dysbiosis (intestinal bacterial imbalance), and gastrointestinal inflammation associated with these conditions, with stress or poor diet, being key offenders.

This is one area of medicine where natural therapies trump conventional approaches, especially since there are few conventional approaches to begin with. In fact, various prescription medications often cause or contribute to IBS. Elimination of the underlying cause in conjunction with a whole foods diet provides wonderful, long-lasting relief.

IBS Symptoms

Allopathic (conventional) medicine diagnoses IBS if symptoms are present for at least 6 months, you experience abdominal pain or discomfort at least 3 days each month, and at least one of the following statements are true:

• The pain/discomfort is relieved by having a bowel movement
• The pain/discomfort in linked to a change in how often you have a bowel movement
• The pain/discomfort is linked to change in the appearance or consistency of your stool

In addition, the following symptoms are characteristic of IBS:

• Constipation (less than three bowel movements per week, though less than one bowel movement daily is noteworthy)
• Bowel movements may differ in size or consistency (may be hard and small, pencil thin, or loose and watery)
• The way stools pass changes. You may strain, feel an urgent need, or feel that you haven’t completely passed a stool
• Bloating or a feeling of gas in the intestines

Other symptoms include:

• Lower abdominal pain with constipation that is sometimes followed by diarrhea
• Pain with constipation but no diarrhea
• Intestinal gas
• Passage of mucus in stools

Non-gastrointestinal symptoms include:

• Anxiety or depression
• Fatigue
• Headache
• Unpleasant taste in mouth
• Insomnia not caused by pain of IBS
• Sexual problems, such as as pain during sex or reduced sex drive
• Heart palpitations
• Urinary symptoms

Etiology

As mentioned above, there are several possible factors that cause IBS, including infections, celiac disease, increased intestinal permeability, serotonin imbalances, hormonal imbalances, environmental sensitivities, and more.

In addition, food sensitivities and intolerances, dysbiosis, stress, and the associated GI inflammation associated with these conditions as well as poor diet are usually key suspects. A description and explanation of each of these is discussed below:

Food sensitivities: Food sensitivities are found in one-half to two-thirds of people with IBS (Digestive Wellness, 288). Food sensitivities stimulate an immune response in the gastrointestinal tract. Different immune cells use antibodies, which are the equivalent of sharpshooters, or cytokines, which can be likened to shotguns, in order to destroy the invading antigen (foreign invader).

As immune cells call for reinforcements, surrounding tissue can eventually be damaged, resulting in inflammation. This can trigger a number of symptoms and conditions, one of which is IBS.

In one study, participants’ Immunoglobulin G (IgG) sensitivities were tested, and the offending food removed. After elimination for 8 weeks, symptoms were relieved completely in 31.4% of subjects and remarkably decreased in 34.3%. The researchers concluded “Abnormal immune reactions mediated by IgG antibodies coexisted in patients with IBS. It is of great significance in treating IBS by eliminating the allergic foods according to the serum level of food-specific IgG antibodies” (Dept. of Digestive Disease, 2007).

Food intolerances: Food intolerances present another form of reaction to food.

For example, those with lactose intolerance don’t have the lactase enzyme and therefore cannot break down the milk sugar, lactose. In fact, lactose intolerance is a very common cause of IBS. A recent study of 142 people found that 55% of subjects with IBS tested positive for a lactose intolerance compared to 33% of the healthy control subjects (Dept. of Gastrointerology, 2007).

Intolerances to other food, including gluten, sucrose, fructose, or sorbitol can aggravate IBS symptoms as well.

Dysbiosis: As mentioned above, dysbiosis is an imbalance in the flora of the intestines. Approximately 4 pounds of beneficial bacteria reside in the colon. These bacteria have a number of responsibilities, including the continuation of food digestion, the manufacture certain vitamins, supporting the immune system and regulating peristalsis, which is the wave-like motion that propels digestive products downward from the esophagus to the anus.

An imbalance in this flora can cause a variety of health aspects, including IBS. Yeast overgrowth, one form of dysbiosis, interferes with sugar/carbohydrate metabolism as yeast ferments sugar, creating symptoms such as gas, bloating, constipation and diarrhea, among others.

Dysbiosis can also hinder peristalsis, causing digestive products to sit in the GI tract. Pathogenic bacteria, such as giardia, parasites, or C. dificile, present another problem, once again resulting in IBS symptoms.

Stress: This is a huge contributing factor to IBS. Stress activates the sympathetic nervous system, which shunts blood to the working muscles (in preparation for “fight or flight”) and away from the GI tract and digestion. In addition, stress “silences” the enteric nervous system, the “second brain” that assists the central nervous system in regulating intestinal activity and preventing the secretion of gastric and digestive juices.

Once again, food ferments or putrefies and sits in the GI tract rather than being broken down. Once again, peristalsis also ceases, so food simply sits in the intestines.

Inflammation: In addition to poor diet, all of the above factors create inflammation in the GI tract over time. Biologists at the Technische Universitaet Muenchen (TUM) have shed new light on the matter: They have discovered mini-inflammations in the mucosa of the gut, which upset the sensitive balance of the bowel and are accompanied by sensitization of the enteric nervous system, resulting in IBS (German Research Foundation).

Inflammation itself is not a condition, but rather the result of the immune system responding to a perceived invasion which can damage the surrounding tissue if it is chronic.