It is estimated that as many as 1 in 3 people in the UK suffer from some kind of IBS symptoms. People are lead to believe there is no permanent or definitive cure for this ailment, but this is not the case.
Symptoms range from mild to severe and include the following: diarrhoea/loose stools or going to the toilet more than three times a day, constipation or hard to pass stools, or going to the toilet less than three times a week (sometimes alternating between these two, or just one or the other), intestinal cramping and pain, nausea, gas, bloating, fatigue and depression/anxiety relating to the onset of the condition.
Conditions such as celiac disease, inflammatory bowel disease, parasitic infection, fructose mal-absorption, small intestinal bacterial overgrowth and bile acid mal-absorption all need to be ruled out before a diagnosis of IBS can be made. However these would be identifiable triggers for this type of symptoms very similar to IBS.
It is thought that imbalances in the gut flora and immune system are possibly at the root of IBS. Another consideration would be how well the adrenal glands are functioning, as these control inflammation in the gut through a hormone called cortisol. There is also a possible link to a gut imbalance called candida, which may trigger these types of symptoms along with other symptoms unrelated to the gut, which can be assessed more closely with a Nutritional Therapist. Normally when IBS occurs it co-exists with a condition called leaky gut. This condition is the by-product of chronic inflammation, which leads to tiny perforations in the gut lining, and from this sensitivities to foods develop, which create more inflammation and so the cycle continues.
Any gut/hormonal/immunity imbalances can be diagnosed with a range of tests from a biomedical lab to ascertain the true cause of this issue.
There are many positive changes you can make to improve this condition and even rid yourself of this sometimes debilitating issue, which I am going to outline now for you in this article.
There are a number of factors to consider when treating IBS. These are mainly dietary, lifestyle and psychological factors. In addition to this supplementation is an important consideration as an essential part of the therapy.
Exclusion diets- Cutting out one or more of the following food groups for 2 weeks initially may help to pinpoint what is causing your IBS symptoms, especially if you have an intolerance to any of these major culprit foods people often have an issue with such as- gluten, dairy, soya, eggs or fructose. You can keep a food and symptom diary to monitor any food triggers and this can show if the food that you cut out was the issue. If so leave this food out of your diet for at least 3- 6 months and reintroduce at a later date and monitor your symptoms. If you suspect you have multiple intolerances, which can often be the case you will have to cut out one food at a time and challenge this by reintroducing it briefly to see if this is having an effect and if it is keep this out of the diet for a longer period of time and then eliminate the next single food you think may be an issue, then challenge that by re-introducing it briefly and so on for each food you feel could be an issue for you. Normally as you heal your gut these intolerances clear up, but it can take some time and patience.
Sometimes also you may need the guidance of a Nutritional Therapist as this can get fairly complicated. There are some foods that you may always have an issue with due to genetic disposition, such as gluten and dairy, which you may feel that you do better without eating as a whole and you feel the issues it causes override the need to eat it. Again a Nutritional Therapist can work with you to adapt your diet to one that is free of these foods.
Reducing foods high in fibre may help diarrhoea, but if you have predominantly constipation then fibre would be a good thing to include, especially insoluble fibre found in whole wheat, whole grains, wheat bran, corn bran, seeds, nuts, barley, couscous, brown rice, bulgur, zucchini, celery, broccoli, cabbage, onions, tomatoes, carrots, cucumbers, green beans, dark leafy vegetables, raisins, grapes, fruit, and root vegetable skins, as it helps to bulk out the stool and have a mildly laxative effect on the gut.
Soluble fibre is better tolerated by people with predominantly diarrhoea related IBS such as oatmeal, oat cereal, lentils, apples, oranges, pears, oat bran, strawberries, nuts, flaxseeds, beans, dried peas, blueberries, psyllium, cucumbers, celery, and carrots, as it slows the emptying of the stomach down and is easy to break down.
Limit spicy foods if you are prone to diarrhoea as these can irritate the gut and lead to IBS episodes.
Reducing sugar and refined carbohydrates in general may help, as these are inflammatory and could trigger IBS episodes. Sugar also imbalances gut flora and suppresses the immune system for three hours each time you eat it!
Reducing or eliminating caffeine can help prevent IBS episodes, as this can prove an irritant to the gut, so experiment with this also.
Reducing or cutting out alcohol may also help IBS type symptoms as this is an irritant to the gut and also imbalances gut flora. See how you feel when you cut this down or out completely- easier said than done I know!
Digestive enzymes help to break down foods properly whilst the gut is too inflamed to deal with this and also when the food is broken down properly it helps prevent things like fermentation or putrification of certain foods that can lead to feeding the non-beneficial bacteria, which causes inflammation and immune dysfunction.
Probiotics help to replace and balance the gut flora needed to soothe and heal the gut. They help to fight against multiple infections that may be present in the gut.
Saccharomyces boulardii is another form of a kind of probiotic that is very good for the immune system, inflammation and also combats against any candida in the gut if that is the cause of your IBS.
Glutamine aids in the rebuilding of the gut lining that is normally damaged (leaky gut) from inolerances to foods, infection and other irritants to the gut wall. This will help the symptoms of IBS and help absorption of food that will indirectly prevent any IBS symptoms.
Fish oil is very beneficial for soothing an inflamed gut and also helps fight against infections as it supports the immune system.
A good multivitamin and mineral supplement will help to provide many vitamins (especially antioxidants) and minerals that fight against infection and prevent inflammation, which should have a positive impact on the symptoms of IBS.
Stress management is key in IBS. There seems to be a bit of chicken and egg scenario here- which came first and what triggers what? It is known that there is a gut and brain connection, so stress will directly impact IBS symptoms. There is also a link to the adrenal glands which are responsible for dealing with the body’s stress response, so chronic stress will lead to an imbalance of gut flora and inflammation, which can trigger the onset of IBS, but it is not as simple as this as there are many other factors that could have led to an imbalance of gut flora which I will outline below and then stress may have been the final tipping point when everything else was already lined up to trigger this. Stress can definitely perpetuate and exacerbate this condition, so it is vitally important that you deal with any chronic stress in your life. It can just even be a case that the unpredictability of this condition can leave you feeling stressed out! Take up a yoga or meditation class, have some therapy if the issues run deeper than that.
The many other possible causal factors of IBS may be an over use of antibiotics, the contraceptive pill, an over use of NSIADs medication, an unhealthy diet full of too much of the above foods I mentioned that can trigger IBS, a bereavement or major stressful event in your life rather than chronic stress, adrenal burn out from taking on too much and not resting enough/partying too hard, food allergies/intolerances, other medications that irritate the gut such as insulin or a bacterial/parasitic infection from travelling abroad that leads to chronic gut issues. All these factors need to be addressed as well in order to treat from a fully holistic perspective.
Gentle to moderate exercise is best for people with IBS as too much exercise can produce excessive adrenaline and this will affect the levels of that hormone I mentioned called cortisol produced by the adrenals, which is responsible for preventing inflammation and indirectly the health of your gut.