Do you suffer from Irritable Bowel Syndrome (IBS) or have some of the signs and symptoms? You may be sick and tired of having constipation day in day out, or bouts of diarrhoea, or a combination. You may be feeling bloated, or have nausea and pain. Overall this condition is really affecting your zest for life.
Up to 50% of visits to the GP for gastrointestinal complaints are for IBS. IBS is the most common functional disorder of the digestive system and there is no definitive cause. Instead it is multi-faceted which is where naturopathy helps to pin-point, alleviate and better manage your symptoms.
The symptoms vary from person to person and whilst the cause is unknown, research is shedding light giving a little more understanding of the condition. IBS is debilitating to those who suffer from it, and it affects up to 20% of the world-wide population – predominantly women.
The signs and symptoms are multiple and include any combination of:
- Alternating constipation and diarrhoea
- Abdominal pain or lower back pain
Exacerbating factors are numerous, and they vary from person to person. They can be very complex. Amongst the research undertaken, major areas of concern, and things that have proven to have a negative impact on the gut – leading to the condition include:
- poor gastrointestinal (gut) flora
- inflammation of the gut wall mucous membrane
- maladaptive or poorly handled stress causing effects via the gut-brain-axis
- genetic influences
- history of digestive tract infection – e.g. parasite
- history of digestive tract surgery – e.g. removal of gall bladder
Poor gut flora
Many factors influence the health of your gut flora or microbiome, including your dietary intake, the way you handle stress, and your history of using antibiotics. One area that we can have control over from the get go, is dietary intake. Healthy gut promoting foods, such as prebiotics, include the fibres which provide fuel for our little ‘good gut bugs’ or microbes in our large intestine. Prebiotic foods include artichokes, olives, sauerkraut, kimchi and other fermented vegetables, garlic and onions, asparagus, bananas, legumes, barley, wild greens, tomatoes and the fibre in our fruits and vegetables. The Mediterranean style diet is prolific in both prebiotic and probiotic foods and hence is health promoting.
Inflammation to the gut wall mucous membrane
Inflammation of the digestive tract is caused by various factors. Such factors could include having history of a parasite infection, undiagnosed food intolerances or allergies, and stress. Sometimes it can be a ‘chicken and egg’ scenario because, the food intolerance may not have been there before the inflammation set in and vica-verca. Research has shown that stress can play a part in causing intestinal permeability (commonly known as ‘leaky gut’) as the brain communicates to the gut through the gut-brain axis – the vagal nerve. What happens is the mucous membrane becomes porous, and food particles escape through the membrane leading to inflammation, gut damage and poor nutrient absorption. Food intolerances and/ or allergies should be identified, but can be a little tricky in the case of an intolerance, especially with delayed immunoglobulin reactions (IgG and IgA).
Poorly managed stress
A person who is highly stressed, or is suffering from anxiety or depression may experience some typical IBS symptoms, such as poor bowel function – diarrhoea and/or constipation and bloating. This is because our nervous system for digestion (parasympathetic) is the complete opposite to the nervous system that responds to stress or anxiety (sympathetic). A meta-analysis of functional magnetic resonance imaging (MRI) reported differences in patients with IBS in terms of brain responses relative to abdominal bloating. The communication channels via the brain-gut axis where messages in the brain influence the automatic response on digestion cannot be underestimated. Further, research has found that a poorly diverse microbiome (gut flora) may instigate poor handling of stress, which again creates a chicken-egg scenario, of knowing which comes first.
Within the nervous system, which operates gastrointestinal function called the “enteric” nervous system, we have a neurotransmitter called serotonin. Serotonin assists in the operation of gut function in terms of motility, sensation and mucosal secretion. Research has found that genetic polymorphisms (or genetic tweaks) may influence the amount of serotonin bioavailability in the gut. For example, too much serotonin may influence diarrhoea, whereas too little serotonin may influence constipation.
History of parasitic infection
Parasitic infection can be harmful if mismanaged, misdiagnosed or mistreated (e.g. overuse of, or non-specific antibiotic usage). Unfortunately, our invading gut bugs are extremely clever and they create a biofilm around their colony to guarantee their survival in your gut. As mentioned it is paramount to have a diverse and healthy gut microbiome in the first place. Post gut bug infection (if not treated adequately), contributes to inflammation and poor gut flora, lowering the immune response and causes further digestive issues.
History of digestive tract surgery
Digestive tract surgeries, such as the removal of the gall bladder can affect bowel function. The gall bladder is responsible for holding bile acid that is produced in the liver. Once you eat, the gall bladder spurts out the bile to digest the fats in your food.
Bile also has a ‘laxation’ effect on the bowel, which assists with constipation or a sluggish bowel. Without a gall bladder, the liver ‘drip feeds’ the bile, rather than having it held in a concentrated form, for release under the stimulus of digestion.
How can naturopathy help IBS?
Naturopathic protocols are individualised and formulated based on subjective and objective information gathered. The aim is for the treatment protocol to be finely tuned, considering all potential influences of the condition. A thorough history is taken to identify major areas of concern. Further testing may be required (eg. to identify or rule out any food intolerances or allergies) or to measure your stress response. Dietary and lifestyle recommendations form the foundation of your treatment plan, with nutritional and/or herbal medicine prescription to provide relief from symptoms and to improve your quality of life.
Please get in contact with me if you would like to know how naturopathy can assist you with alleviating and better manage your symptoms of IBS. The information in this blog is sourced from recent peer reviewed scientific journals. References are available on request.