IRRITABLE BOWEL SYNDROME
IBS is a common disorder of the intestines that is also called spastic colitis. The structure of the bowels is normal but the function is abnormal. The exact cause is not known. Symptoms typically are alternating diarrhea and constipation, along with excess gas, bloating, nausea, decreased appetite, flatulence and a feeling of incomplete emptying after a bowel movement. Large meals may aggravate the symptoms. Conventional treatment includes adding fiber to the diet, medication to relieve spasms, anti-diarrhea drugs, and avoidance of alcohol and caffeine. A standard medical workup may include flexible endoscopies of the stomach and colon, barium x-rays of the upper and lower GI tract, stool culture for bacterial infection, and a stool exam for parasites. The primary focus is to eliminate serious medical conditions, not to find the actual cause of the symptoms.
Holistic physicians believe that food allergies, sugar intolerance, parasitic infection, Candida yeast overgrowth and psychological stress are often contributory factors. A search for these potential causes may require a comprehensive stool analysis (includes more than a simple culture and parasite exam), diary recording of symptoms to pinpoint triggering factors, intestinal permeability functional testing for leaky gut syndrome and a detailed dietary history.
The diet is very important and should include gradual addition of high fiber raw or steamed vegetables. Symptoms should be monitored since some foods may worsen them. Addition of unprocessed psyllium seed powder will help regulate bowel movements. Adequate water intake is essential and should be 6-8 glasses daily. Food should be thoroughly chewed in a relaxed atmosphere. Sugar causes slowing of motility and should be avoided. The addition of live cultured acidophilus and bifidus bacteria helps to normalize the bacteria in the bowels. L-glutamine, an amino acid that intestinal cells use, may be helpful.
Food sensitivity is a very common factor, so a trial of eliminating the most common food offenders is worthwhile. The offenders most often found are dairy, wheat, coffee, chocolate, citrus fruit, corn, eggs, nuts, barley, rye, oats, potatoes, tea and onions. After 1-2 weeks off these foods, if your symptoms are better, slowly reintroduce one new food every 4-5 days and keep a food and symptom diary.
Peppermint oil in enteric-coated capsules has been shown to be helpful in clinical trials. Herbal teas such as chamomile, peppermint, rosemary and valerian may calm the distressed bowels.
Insight oriented psychotherapy, relaxation training, biofeedback, hypnosis, and meditation all have the potential to markedly reduce the symptoms. Many people with IBS are overly controlling and self-critical. They may have issues about trust and often have unresolved childhood issues. Ongoing work to change the beliefs and behaviors contributing to this chronic functional disorder has the potential to bring complete relief.
Daniel Blodgett MD