Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is a common disorder of the intestines that leads to abdominal cramping, pain, bloating, and changes in bowel habits. Often it is just a mild annoyance, but for some people it can be disabling. Most people with IBS, however, are able to control their symptoms through diet and stress management.

Written By Samar Tarabay, Quest Nutritionist

IBS is the most common digestive disorder. Twice as many women suffer from the condition as men and it usually affects mainly middle-aged people. 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 materials, and leads to the accumulation of mucus and toxins in the intestine. This accumulated material partially obstructs the digestive tract, trapping gas and stools, which in turn causes bloating, and constipation. Some people with IBS have constipation, others have diarrhoea and some people experience both. Sometimes the person with IBS has an urge to move the bowels but cannot do so. It causes a great deal of discomfort and distress, but it does not cause permanent harm to the intestines or lead to a serious disease.

IBS has also been sometimes called intestinal neurosis, mucous colitis, spastic colitis, spastic colon and functional bowel disease. However, most of these terms are inaccurate. For example, colitis means inflammation of the large intestine, but IBS,
however, does nor cause inflammation and should not be confused with other disorders. There are no physical signs of disease in the bowel tissue with this disorder, and its cause is unknown.

What Causes IBS?

One theory is that irregularities in the intestinal hormones responsible for bowel motility are behind this disorder. According to this theory, people with IBS have abnormal contractions of the smooth muscle of the digestive tract. Some scientists believe a virus or bacterium may play a role. Lifestyle factors such as stress and diet are common causes, as are food allergies. IBS sufferers seem to have a colon that is more sensitive and reactive than usual, so it responds strongly to stimuli that would not bother most people.

Certain medicines and foods may trigger spasms in some people. Sometimes the spasm delays the passage of stool, leading to constipation. Chocolate, milk products, or large amounts of alcohol are frequent offenders. Caffeine causes loose stools in many people, but it is more likely to affect those with IBS. Researchers have found also that women with IBS may have more symptoms during their menstrual periods, suggesting that reproductive hormones can increase IBS symptoms. The overuse of antibiotics, antacids, or laxatives, which disturb the bacterial microflora of the bowel, may also be a factor.

What Are the Symptoms of IBS?

People with IBS usually have abdominal cramp with painful constipation or diarrhoea, flatulence, intolerance to certain foods and traces of mucus in the stools. Pain is often triggered by eating and may be relieved by bowel movement. Because of the symptoms experienced, a person may avoid eating, leading to nutrient deficiencies. Also, malnutrition may result because nutrients are not absorbed properly. As a result, people with IBS require as much as 30% more protein than normal, as well as increased intake of minerals and trace elements which can quickly be depleted by diarrhoea. Bleeding, fever, weight loss, and persistent severe pain are not symptoms of IBS but may indicate other problems.

How is IBS Diagnosed?

Diagnosis of IBS requires ruling out disorders that can cause similar symptoms, such as coeliac disease, colon cancer or benign tumours, Crohn's disease, depression, diverticulitis, endometriosis, food poisoning, ischemic or ulcerative colitis, and lactose intolerance.

Dietary Recommendations

• Eat a high fibre diet including plenty of fruits and vegetables, plus whole grains and legumes. You may even try taking supplemental fibre. Psyllium powder regulates bowel movements. You may also use oat bran and ground flaxseeds.
• Avoid animal fats; butter; carbonated beverages; coffee and all other substances containing caffeine; chocolate; all dairy products; fried foods; ice cream; all junk foods; additives mannitol and sorbitol; margarine; nuts; orange and grapefruit juices; pastries; all processed foods; spicy foods; sugar; and wheat bran and wheat products. These foods encourage the secretion of mucus-producing foods such as beans, broccoli, and cabbage.
• Avoid alcohol and tobacco; these irritate the linings of the stomach and colon.
• Check to see if you have food allergies as they are important factors in this disorder.
• Avoid grains, nuts, and seeds until symptoms subside.
• Eating the correct diet, using supplemental fibre and drinking plenty of water are very important in controlling IBS. Early recognition of IBS and good nutrition can help minimise complications.
• Stress management also relieves symptoms.
• An imbalance of gut flora is common in those with IBS. Usually, the pathogenic flora outnumber the friendly bacteria.

Probiotics and IBS

The gut flora play an important role in maintaining normal intestinal function. However not all bacteria are beneficial. The health of the digestive system is dependent on maintaining a delicate balance between the desirable and undesirable bacteria found in the gut. When this balance is disrupted, disease and inflammation can occur. The consumption of friendly bacteria has also been shown to help IBS sufferers reduce their symptoms and they can also produce essential vitamins such as vitamin K, which is vital for the healthy clotting of blood, and some B vitamins, which are important for energy production.

Beneficial bacteria, also known as probiotics, include Lactobacillus acidophilus, Lactobacillus casei, Lactobacillus rhamnosus, Lactobacillus plantarum 299v and Bifidobacterium longum. Parabiotics reduce the presence of undesirable bacteria by competing for adhesion sites and nutrients, producing antimicrobial substances and lowering the pH of the digestive tract through the production of short chain fatty acids.

L.plantarum is a member of the Lactobacillus family of micro-organisms and has been found to populate a healthy human gastrointestinal tract. Scientific studies show that this particular strain of probiotic has adhesion properties which allow it to temporarily colonise the large intestine.

Lp299v and Irritable Bowel Syndrome Lp299v is a highly specific strain from the plantarum group of friendly bacteria. This strain differs from other plantarum species because it has been extensively researched regarding its use for those with digestive conditions and, in particular, Irritable Bowel Syndrome. Studies have shown that Lp299v could decrease the frequency, severity and duration of up to 90% of symptoms experienced by IBS sufferers. However, this particular strain has also been associated with a therapeutic role for conditions such as diarrhoea and heart disease and has also been shown to help boost the immune system at the gut level.

One study found that 95% of patients receiving Lp299v for just 4 weeks showed significant improvements in all IBS related symptoms including bloating, diarrhoea and constipation.

Herbal Advice

• If you have IBS, it is wise to treat your liver as well as your digestive tract, preferably with silymarin (milk thistle extract). Other beneficial herbs are burdock root and red clover, which are good for cleansing the bloodstream, and thereby the liver.
• Alfalfa contains vitamin K, needed to build intestinal flora for proper digestion, and chlorophyll for healing and cleansing of the bloodstream.
• Aloe vera is healing to the digestive tract.
• Peppermint aids in healing and digestion, and also relieves upset stomach and bloating. It must be taken in enteric coated capsule form to prevent the oil from being released before it reaches the colon.
• Valerian is also helpful for the nerves that regulate intestinal muscle function. Therefore helps to calm muscle spasms of the digestive tract.
• Ginger root extract may be useful for IBS sufferers. Ginger has a calming effect on the digestive system, thereby alleviating gastrointestinal distress and may help to reduce diarrhoea.

IBS can be painful and may even be a crippling digestive disorder that can affect our daily routine and quality of life if the right measures are not taken. The severity and occurrence of symptoms, however can be controlled if the sufferer follows a suitable diet and avoids food allergens. Stress management and learning relaxation techniques may also considerably reduce the symptoms. It may also be prudent to maintain healthy gut microflora by eating foods that promote the accumulation of friendly bacteria. In addition to this it is important that probiotic supplements are consumed, particularly those which contain Lactobacillus plantarum 299v.

Irritable bowel syndrome is painful, but not serious, and most people who have it can lead active, productive lives if they change their diets, get regular exercise, and maintain a healthy gut microflora. TT

© Samar Tarabay, Quest Nutritionist
For further information on the Quest range of products or for other nutritional information contact the Quest nutritionists on 0121 359 0056 or email nutrition@questvitamins.co.uk

Reproduced with the kind permission of Today's Therapist