Irritable bowel syndrome (IBS) is on the rise. It has a worldwide prevalence of 10-20% and has become one of the most common disorders seen by gastroenterologists and primary care physicians alike. I myself have noticed an increase in the number of patients with digestive health disorders in our clinic. I thought it would be helpful to write this blog post because many patients ask, “What is IBS, and how do I know if I have it?”
Symptoms:
IBS is a condition occurring in the large intestine, which can produce a number of symptoms. Though it affects each person differently, the hallmark of IBS is abdominal discomfort or pain. The following symptoms are also common:
Abdominal cramping and pain that is relieved or partially relieved with a bowel movement.
Diarrhea, constipation, sometimes alternating bouts of diarrhea and constipation.
Change in frequency or consistency of stools.
Gas, and bloating.
Causes:
The cause of IBS is currently unknown. Factors that appear to play a role include:
Abnormal muscle contractions in the intestine - The walls of the intestines are lined with layers of muscle that contract as food moves through the digestive tract. Contractions that are stronger and last longer than normal can cause gas, bloating and diarrhea. Weaker contractions can slow food passage and lead to hard, dry stools that are difficult to pass.
Nervous system - Abnormalities in the sensory nerves in the digestive system or a disruption in the communication between the brain and the GI tract can cause your body to overreact to changes that normally occur in the digestive process (such as the stretching of the abdomen from gas or stool), resulting in pain, diarrhea or constipation.
Inflammation in the intestines - Inflammation causes an increase in the number of immune-system cells. A heightened immune-system response is associated with pain and diarrhea.
Infection - IBS may develop after a bout of gastroenteritis (stomach flu) caused by a bacteria or virus. IBS might also be associated with an imbalance of bacteria in the intestines (for example, SIBO aka small intestinal bacterial overgrowth).
Changes in the gut flora - Microflora are the "good" bacteria that reside in the intestines and play a key role in health. Research indicates that people with IBS might have a microflora that differs from those in healthy people.
Diagnosis:
IBS can be difficult to diagnose. A combination of health history, physical examination, and selected tests are used to help diagnose IBS. Some tests include laboratory studies, imaging studies (such as a CT scan or X-rays), and endoscopy and/or colonoscopy.
At Double Happiness Health, besides our Chinese medical assessment, when needed we can provide a comprehensive stool analysis that used DNA methodology to gives us insight into your microbiome called the GI MAP. It rules out imbalance in you intestinal flora, underling infections of bacteria, fungus or parasites. The GI MAP also looks at intestinal markers to see how well your body is secreting digestive enzymes, clearing toxins and managing inflammation. This data helps us pinpoint what may be causing your symptoms and resolve it.
Treatment:
Often times, IBS symptoms can be quite restricting to an individual’s quality of life. Your M.D. may prescribe medications can sometimes offer relief. However, some individuals don’t respond to medications or find the side effects intolerable. The good news: A holistic approach can help address the root cause and provide lasting relief. Even without fancy testing, there are several well-studied, non-pharmaceutical, holistic approaches that can help to reduce IBS-related symptoms and restore a sense of control and one’s quality of life.
Stress Reduction. The gut is home to the “enteric nervous system” also known as the ‘second brain’ - see my blog post about the gut-brain connection. Digestion is the main duty the enteric nervous system. As many people experience, digestion can be intimately related to a stressor or emotion, thus it’s common for IBS to be connected to a stress or emotional component. Stress hormones can alter movement in the gastrointestinal tract (speeding it up or slowing it down) and cause intestinal muscles to spasm, thus causing pain. Additionally, IBS symptoms and the disruption they cause can themselves become a source of stress, creating a vicious cycle of stress and discomfort. Developing an intentional program to help manage stress and realign the balance of the nervous system can be integral to managing IBS.
Diet and supplements. When it comes to IBS, there is not a one size fits all diet, but there are basics that can start you on the road to understanding the best diet for you. To begin, focus on a whole foods based diet, and remove refined flour, sugar and processed food. In Chinese medicine, we also work with the energetics of food and recommend cooked vs. raw vegetables and the implementation of soups and stews with bone broth as a healing diet. Many people have underlying food sensitivities that they have not identified. You may consider an elimination diet to discover if you have specific foods that irritate you.
Studies have found that foods high in dietary sugars known as fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) can exacerbate IBS symptoms. FODMAPs provide fuel for certain bacteria in the gastrointestinal system, causing abdominal pain and bloating. A low-FODMAP diet can be a short-term therapeutic diet while to help reduce abdominal pain, bloating, diarrhea, and constipation associated with IBS. This diet is not a long term solution, as it does not provide enough fiber and nutrients to the diet. It It is best used in conjunction with a treatment designed by your practitioner.
Reducing the intake of gluten, a protein found in wheat, rye, and barley may also help. Even if you don’t have celiac disease, gluten can possibly modify the barrier function of the gut lining.
For those with constipation-predominant IBS, soluble fiber can be beneficial. Soluble fiber can be taken as a supplement and is also found in foods such as beans, oats, avocados, and dried prunes. Consume plenty of water with fiber to avoid worsening constipation.
Some developing studies have found that probiotics reduce pain and symptom severity in IBS. Probiotics contain the “good” bacteria to help maintain digestive health.
Peppermint oil, taken as enteric-coated capsules, can relax the smooth muscles of the gastrointestinal system, and thus help reduce abdominal pain and cramping associated with IBS.
Here’s how we can help you with a holistic approach:
We’re here at DHH to support you with acupuncture, diet, herbal, and supplement guidance. When needed we can provide comprehensive stool testing to rule out an underlying infection or disruption in the microbiome of your gut. Acupuncture and other stress-reduction techniques we recommend can help reduce abdominal IBS-related symptoms. Traditional Chinese Medicine (TCM) examines the underlying cause of digestive dysfunction. Our approach takes into account your individual physical, mental, and lifestyle needs to help restore harmony and thereby reducing abdominal pain, promoting more normal elimination, and improving your digestive health.