Irritable Bowel Syndrome (IBS)
In this study published by the Journal of Human Nutrition and Dietetics 135 IBS sufferers completed a survey on their view of the role of diet to their symptoms and the majority felt that their symptoms were related to food. A similar questionnaire was used to investigate the perceptions of 111 healthy subjects to the gastrointestinal symptoms experienced on the consumption of food.
The survey concluded that the majority of IBS sufferers consider their symptoms related to food. Some then proceed to change their diet completely limiting foods that they perceive to be the problem. This however is not advisable and could possibly expose them to an increased risk of nutritional deficiency by not seeking professional advice.
IBS is the most common digestive complaint seen by physicians and can regularly make life hell for sufferers. It is now one of the most commonly diagnosed digestive conditions with up to 20% of Irish people suffering from the condition. Symptoms however can vary hugely from individual to individual ranging from mild pain to severely debilitating. More than twice as many women suffer from the condition as men. The symptoms are unpleasant like painful stomach cramps, bloating, diarrhoea, constipation and even alternating constipation and diarrhoea, flatulence, intolerance to certain foods, mucus in stools and nausea, severe headaches and even vomiting. Sometimes because of the severe pain a person with IBS can literally dread eating because of the cramps that can follow.
Irritable Bowel Syndrome (IBS) explained
In IBS the normally rhythmic muscular contractions of the digestive tract become irregular and uncoordinated. This interferes with the normal movement of food and waste material and leads to an accumulation of mucus and toxins in the intestines. The accumulation sets off a partial obstruction of the digestive tract, trapping gas and stools which in turn leads to bloating, distension, constipation or an urgency to defecate. Pain can be triggered by eating and relieved by a bowel movement.
There are no physical signs of disease in the bowel tissue with this order, and its cause is unknown. Some scientists believe a bacterium or virus may play a role. Overuse of antibiotics, antacids, or laxatives which disturb the bacterial micro flora of the bowel may also be a factor.
IBS is generally diagnosed by a process of elimination of all other gastrointestinal conditions like Inflammatory Bowel Disease, lactose intolerance and colon cancer. Tests are usually carried out by an endoscopy and colonoscopy to rule out more serious conditions if over 50 when developing the symptoms or if there is a family history of bowel cancer.
So what happens after you have had endoscopy and colonoscopy done?
After your consultation with a gastroenterologist and when no underlying disease is found the conventional treatment is as follows:
- Anti-spasmodics are prescribed to control colon muscle spasms (Buscopan and Colofac are common OTC brand names).
- Peppermint oil capsules are also anti-spasmodic and are available as over the counter medication eg. colpermin.
- Loperamide (Immodium) to treat diarrhoea.
- Laxatives such as ispaghula husk (e.g. Fybogel) for constipation.
- A low dose of tricyclic antidepressants (lower than that used to treat depression) can help relieve intestinal pain.
- Neurontin can also be prescribed in cases where there is nerve damage as a result of constant cramping in the stomach.
In mild cases of IBS, medication can often be successful in treating symptoms but routine or long-term use is not recommended as it can lead to over-dependence and side effects, and these medications do not treat the condition itself.
Think Nutrition Approach to IBS
At Think Nutrition we look at every possible underlying cause of IBS through a process of elimination. We help identify your triggers through a detailed case history. We also do functional testing if we feel this is necessary to eliminate causes and then put forward a plan to restore your digestive system. We use evidence based solutions where there is sufficient scientific evidence to prove they work.
As annoying and painful as IBS is it is not serious and most people can lead active productive lives if they look at their diet, get regular exercise and rest. People with IBS have to be careful as nutrients may not be absorbed due to regular diarrhoea and may need as much as 30% more protein than normal as well as increased intake of minerals and trace elements which get depleted by diarrhoea.
We focus on the following areas to find out the underlying issues:
Sugar Intolerance: can be an underlying cause of IBS and many studies are now showing that sugar intolerance may be one of the major factors contributing to IBS.
Food Sensitivities: are found in 60-70& of people with IBS.
Lactose Intolerance: An intolerance to lactose has been shown to be very common in IBS patients.
Dysbiosis: Intestinal dysbiosis is an imbalance in the microflora of the bowel. In a healthy gut, these microflora synthesise vitamins K, B5 and Biotin, as well as short chain fatty acids.
Insufficient Good Bacteria in the gut: low levels of Lactobacillus acidophillus and bifidobacterium may be associated with IBS.
Parasites: recent studies have pointed to a role for the parasites Blastocystis hominis and dientamoeba fragilis, giardialamblia and Entamoeba hystoylica, in the cause of IBS. We do a comprehensive digestive stool analysis to test for parasites.
Pyschological causes: many studies have shown a higher incidence of anxiety and depression in IBs patients. At Think Nutrition we will not make you feel that it is all in your head or that your symptoms are not real and we will not just offer you a pill to pop, we work with you on identifying your particular triggers and also looking at stress management.
IBS is very real and can cause huge disruption to your life. The gut and brain are closely connected with more nerve cells in the intestines than in the spinal cord. The gut has been called the body’s ‘second brain’, containing 95 percent of the body’s neurotransmitter serotonin and direct nerve connections to the brain, and emotional upset can aggravate your symptoms.
Candida overgrowth: also known as yeast infection is a condition that affects millions of people worldwide and causes symptoms like chronic fatigue, skin rashes, digestive problems or reoccurring vaginal infections. Unfortunately some doctors deny that Candida infections exist, in spite of the evidence and studies that have been done. See more on Candida.
Nutritional Therapy Protocol for IBS
A nutritional therapy protocol for IBS sufferers will vary from person to person, depending on the severity of symptoms, whether is constipation or diarrhoea- predominant, or a mixture of both. What will be successful for one patient could make symptoms worse for another so the plan will be very individual.
It is essential that any dietary changes should be introduced slowly and gradually to allow the digestive system to adjust to the changes.
General Tips on Irritable Bowel Syndrome
- Take time out for food; sit up, eat slowly and chew food.
- Drink plenty of water between meals.
- Eat several small meals instead of 2-3 large meals. Eat at regular intervals to help regulate bowel functions.
- Avoid coffee / tea, caffeinated drinks. Herbal teas like slippery elm and marshmallow are soothing on the digestive system.
- Keep a food and symptoms diary to help identify food sensitivities / emotional triggers.
- Seek out others with IBS. There is a support group based in the UK (http://www.theibsnetwork.org).
Rethink sugar:
- Your favourite fizzy drink in a can has 15 teaspoons of sugar, this is 3-9 teaspoons more than is recommended for your entire day.
- A teaspoon of sugar contains 15 calories.
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