Irritable Bowel Syndrome (IBS)

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Treatment Protocols for IBS

Irritable bowel syndrome (IBS) is a common and debilitating condition that significantly affects the patient’s quality of life. IBS presents with a cluster of gut symptoms, most commonly abdominal pain with either constipation and/or diarrhoea. Other symptoms include bloating and flatulence, with these symptoms varying in frequency and severity between individuals and in the same individual at different points of time.

Key components in IBS include 1) dysbiosis (imbalance of gut flora), 2) hypersensitivity of the enteric nervous system (the ‘gut brain’), 3) a major dietary link (this is examined by food exclusion trials), and 4) intestinal epithelial barrier defect (‘leaky gut’). Due to the many factors often involved in IBS, a holistic approach is required for lasting results, including diet, lifestyle, and digestive support strategies.

Major factors contributing to IBS include:

  • Stress
  • Depression
  • In some cases, eating specific foods, including wheat, dairy products, or citrus fruits
  • In some cases, alcohol or caffeine
  • Familial predisposition (genetics, age, gender)
  • Unresolved pathogenic infection
  • Certain drugs (e.g. NSAID’s) can alter the bowel’s normal motility
  • Hormones – menstruation frequently triggers or exacerbates IBS symptoms, while pregnancy and menopause tend to improve symptoms. Hormone replacement therapy is associated with an increased risk of developing IBS.

Signs and symptoms of IBS are:

  • Abnormal stool frequency (“abnormal” may be defined as > 3 bowel movements per day and < 3 bowel movements per week)
  • Abnormal stool form (lumpy/hard or loose/watery stool)
  • Abnormal stool passage (straining, urgency, or feeling of incomplete evacuation)
  • Passage of mucous
  • Bloating or feeling of abdominal distension
  • Straining during a bowel movement
  • Urgency (having to rush to have a bowel movement)
  • The feeling of incomplete bowel movement
  • Abdominal pain and/or discomfort relieved by defaecating
  • Changes in bowel habits
  • Diarrhoea or constipation, or both alternately
  • Need for bowel movement immediately on waking or after eating

Note: If you suspect you have IBS but have not been diagnosed, it is important to see a Medical Practitioner rule out other possible causes of your symptoms.  IBS-like symptoms can also occur from time to time in patients without the complete syndrome.

Treatment for IBS

IBS is a chronic condition with a range of possible triggers. These triggers can include stress, specific foods, dysbiosis, medications and others. Depending on the cause it may be cured (e.g. dysbiosis), but otherwise it can be managed once the individual understands their triggers and develops strategies to manage them.

In cases where a pathogenic infection has preceded IBS (e.g. travellers diarrhoea, giardia) Jodie takes specific steps to address the biofilms* that can develop in those who suffer from IBS related to past infections.

Herbal Medicines, Diet and Lifestyle play an important role in recovery.

  • Herbal Medicines (most have multiple actions and Jodie chooses herbs that are beneficial to other health conditions you may have): Chamomile, Marshmallow, Slippery Elm, Berberine herbs (Barberry, Golden Seal, Phellodendron), Garlic, Turmeric, Dandelion, Gentian, Cinnamon, Thyme and others
  • Nutrients: B Vitamins, Magnesium, Glutamine, Vitamin D3, Zinc, Vitamin C, NAC and others
  • Probiotics: L. Plantarum (299v), Lactobacillus rhamnosus GG (LGG), L. paracasei (LP-33), Bifidobacterium lactis (BB-12) and others
  • Binders (for endotoxins if relevant): Charcoal, diatomaceous earth, pectin, high tannin teas
  • Diet: Anti-inflammatory diet, Low FODMAP diet**, Identify food intolerances, low alcohol and caffeine, minimise processed foods
  • Lifestyle factors: Stress is a common trigger in IBS and strategies such as exercise, relaxation techniques, improving quality of sleep and adequate rest time can all help to ease the severity of symptoms.

* Bacteria are capable of adapting to avoid (and hide) from our immune system. They can form biofilms which effectively ‘shield’ them from our immune system. In chronic health conditions, breaking down biofilms is a key strategy in supporting the body to recover and heal.

* *A low FODMAP diet is a short term strategy for reducing symptoms (and inflammation). Once recovered from IBS, returning nutritious, well-tolerated high FODMAP foods to the diet is important to gain benefit from their pre-biotic actions (they provide fuel for your good gut bugs!)