by Sinead Fine (MAHA)

At present Irritable Bowel Syndrome (IBS) affects 1 in 6 people in the Western World, with a quarter of these being male and three quarters being female. IBS is classified as a range of gastrointestinal disorders that have no definable cause. A common definition of IBS is “a collection of gastrointestinal symptoms that are thought to be stress related.” Doctors usually bag the term Irritable Bowel Syndrome on symptoms when they have ruled out everything else and tests show the intestines to look and seem healthy. Many doctors therefore believe it is stress related and that the involuntary intestinal muscles in the large intestine react excessively to nerve impulses from the brain when under stress. However as you read over the causes further down, one realises it is not always as simple as blaming stress. IBS is an umbrella term to describe highly varied symptoms in different individuals where different causes and symptoms have to be taken into account in order to develop a programme of recovery. Many are told to live with IBS and that they will suffer for life - I do not believe that this is always the case and sometimes simple changes in lifestyle and diet can cure or at least alleviate it to a great deal.

Symptoms of IBS include pain after eating, in the form of indigestion, colicky stomach cramps and excessive flatulence. Constipation and/or diarrhoea occur sometimes accompanied with mucus. Piles can occur from straining because of constipation or due to excessive diarrhoea. Fatigue, nausea, depression, lack of energy, stomach rumblings and general unease also occur.

When one goes the conventional route the doctor will first rule out any more serious illness, either by examination, questioning or by hospital procedures for the more distressed. If excessive mucus or blood occurs then it is always advisable to get checked out immediately by your doctor. Distress with bowels can be attributed to more serious conditions such as Colitis, Chroans disease, Celiac disease, Diverticular disease, Colon Cancer, obstruction to the bowel, Diabetes, over or under active Thyroid etc.  IBS can also be attributed to bacterial, viral or parasitic infection and stool tests can sometimes indicate infection, though tests are not always very accurate, as often a purged sample in a fixitive solution is needed for accurate testing.

There is also the fact that there are a number of parasites that are not recognised, and therefore are often not looked for. In recent years a parasite called Blastocystis hominus is being blamed for many symptoms of IBS, though many practitioners do not see this parasite as causing a problem, though thousands around the world will testify against this! The colour and texture of a stool can often tell what a problem may be - blood may indicate an ulcer, infection or even colon cancer. Pale, loose, bulky stools usually indicate Celiac disease, where a person has a severe intolerance of gluten found in the grains, Oats, Barley, Rye and Wheat. Caeolics also usually suffer intense pains in the stomach, weight loss and anaemia.

To rule out many disorders a doctor will advise tests to be taken, such as a barium enema, sigmoidoscopy, colonoscopy, and if coeliac disease is suspected, a endoscopic biopsy. If at the end of all the tests nothing is found and the intestines seem to be healthy, then the doctor will label Irritable Bowel Syndrome onto your condition and you will be sent home with anti-diarrhoea tablets, laxatives for constipation or antispasmodic drugs. Some antidepressants also help with bowel problems if caused by stress, and these might be prescribed, especially if depression is a factor. Fortunately as IBS becomes more common doctors are more open to advising massage, hypnotherapy, homeopathy, counselling and psychotherapy as ways to treat distress.

The causes of Irritable Bowel Syndrome are as varied as symptoms and what may cause symptoms in one person, would not in another. The role in self-treating IBS is first to work out the cause and then by trial and error find the right techniques to treat the symptoms. Therefore because there are different causes for IBS there will be different aids and cures for different people.

Some of the causes are listed below:

  • Stress - Often stress is the leading cause of IBS and many peoples symptoms greatly increase when under stress. Many are so unaware of their bodies that they do not even realise they are stressed! Stress management techniques are very important and different relaxation techniques work for different people. Aromatherapy, calming herbal remedies, biofeedback, cognitive behavioural therapy, hypnotherapy, counselling, psychotherapy, massage, reflexology, yoga, tai chi, deep breathing, swimming all help to alleviate stress.
  • Lack of fluids - Caffeine and alcohol has diuretic effects and thus should be avoided. Fluids should be filtered or spring water, herbal teas, cereal drinks and diluted fruit and vegetable juices. Aim to intake one to two litres of fluids per day, in the form of filtered and spring waters, soups and herbal teas. Many see a dramatic effect simply by increasing the fluids in their body. However DO NOT drink with your meals, and for one to two hours afterwards, as excess fluids dilute the gastric juices and may lead to undigested food and bloating.
  • Lack of fibre - Refined diets in the western world are very common with white bread, white pasta, saturated meats, fats and sugar being a routine part of everyday eating. Increasing fibre in the diet often helps IBS though it is very important what type of fibre is increased. Wheat bran is often terrible for the bowels and has a scouring effect on them - and often makes people much worse. A more gentle way of adding fibre is to increase soluble fibre such as that found in fruit, vegetables and cooked grains such as brown rice, oats and millet which are gentle on the system. Many find porridge with added seeds and dried fruit is great first thing in the morning to get the bowels moving. It is also important to be aware that lack of fibre in the diet has been directly linked to colon cancer.
  • Lack of exercise - Lack of exercise leads to impaired blood circulation and lack of muscle tone. This leads to bowel problems especially constipation. Increase all forms of exercise that is enjoyable - no point going to aerobics class when you dread going! Even simple walking massages the abdominal muscles and helps regulate bowel movements.
  • Bad eating habits - Eating food while stressed, rushing, talking or being distracted by television, loud music or even reading can lead to impaired digestion. Not chewing food properly while eating food is another main factor in indigestion. Food breakdown starts in the mouth when enzymes in the saliva work on starches in our food. Also messages are relayed to the brain to tell the body to prepare for food in the form of hydrochloric acid and intestinal enzymes. If food is washed down by liquids or eaten quickly these messages will not work as well. Drink liquids up to half an hour before and then avoid for a few hours - soup is an exception if eaten slowly and not too much at one sitting. Swallowing air with food also leads to flatulence. Basically common sense is a requirement when eating - learn to listen to your body!
  • Allergies or intolerance to certain foods - This is a tricky one, because it can often take ages to find the offending foods. Kinesiology seems to be more reliable than Vega testing is, though newer Vega machines seem to be more accurate. Dowsing can also be fairly reliable. Omitting foods, which are suspected from the diet, and later introducing them back in one by one can often show the intolerant food. People often find avoiding the offending food for a certain amount of time can later lead to it being returned to the diet with no side effects. A main problem in Australia is our reliance on wheat which many become intolerant to - however it is interesting to note that when people convert to organic wheat and bread they suffer less or not at all! One then wonders if it is all the additives and sprays used on wheat crops that causes intolerance or the amount of white bread we eat with all its additives? What some people call brown bread is white bread coloured with caramel, so only go for the whole-wheat grain breads, if wheat is not a problem with you. Other offending foods include grains containing gluten (wheat, oats, barley, rye), corn, soy foods, sugar, citrus foods, eggs, peanuts, certain types of shellfish and artificial sweeteners such as sorbitol. Spicy foods, fatty foods can also greatly irritate the gut, and one may need to eat a very simple diet to overcome IBS symptoms.
  • Overuse of antibiotics - Overuse of antibiotics leads to irritated guts, lack of healthy bacteria and increased risk of later infections. Antibiotics are grossly over prescribed in Ireland, and I have noticed clients who directly begin to suffer from IBS after a strong round of antibiotics or anti fungals. Perhaps one of the reasons women suffer more from IBS is that they are more likely to go to the doctor and get repeat prescriptions of anti fungals for infections such as cystitis and thrush! The more broad-spectrum antibiotics are the worst. Lack of healthy bacteria leads to many and varied symptoms such as allergies, skin problems, leaky gut syndrome, indigestion, wind, flatulence and overgrowth of organisms such as Candida albicans. Candida can evolve in the gut into a mycial form which can puncture the gut wall causing undigested foods to enter the blood stream causing multiple allergies and systemic candida, which causes oral and genital thrush, rashes, foggy brain and so on. Therefore antibiotic use can often lead to further problems down the road, yet antibiotics can save lives – so never refrain from taking them if genuinely needed. One can see the importance of healthy bacteria in the gut (probiotics) to maintain health in the gut and now many food companies realise this and are adding it to many foods and dairy produce.
  • Prescribed medication - Some medications for depression and anxiety can cause cause irritable bowel. Aluminium-based antacids and so on cause constipation or diarrhoea and even the simple iron tablet can cause chronic constipation. Always check with your doctor the side effects of medications especially if you already have IBS.
  • Gut Dysbosis - A leaking of the gut wall (as already mentioned above) due to candida, bacterial, viral or parasitic infection can occur and this leads to IBS as food is poorly absorbed or digested. Antibiotics can also cause gut dysbosis if very strong or used for long periods of time. Here priority is to heal the gut wall to prevent re-absorption of foods. This can be done with supplements such as the animo acid glutamine.
  • Lactose intolerance - An intolerance to lactose (because of a lack of the enzyme lactase) can lead to many symptoms of IBS and simply removing dairy from the diet can create relief or taking the enzyme lactase (available from health food stores) when indulging in an ice-cream or some butter, will help to break the lactose down.
  • Lack of Stomach acid and digestive enzymes - not enough stomach acid causes indigestion and sometimes heartburn. Lack of stomach acid often causes bloating, heaviness in the stomach and flatulence. Lack of digestive enzymes can also lead to bloating, cramps, diarrhoea and constipation. If for various reasons there is not enzymes present, food will not be broken down properly and cause irritation.
  • Stomach irritants - Alcohol is one of the most deadly stomach irritants and often stomach ulcers are a direct cause of excess alcohol in the diet. Many find avoiding alcohol for a period of time and then reintroducing it slowly at a later time can usually indicate which alcohol’s can be taken and which ones must be avoided. The more gentle are weak mead, cider and beers with wine and spirits being more irritating to the gut. Smoking tobacco with its hundreds of irritants and carcinogens affects the digestive organs, being slightly purgative and suppressing appetite. Smoking should be avoided at all costs by those suffering from IBS. Caffeine in coffee (tea and hot chocolate to a lesser extent) also irritates the gut increasing intestinal peristalsis. Theobromine in tea and chocolate is also a stimulant and addictive substance and should be avoided or at least kept to a minimum. One to two cups of tea a day should be the maximum used, if at all and coffee should be avoided. I have often asked clients how much tea they drink and they reply, “Oh, not that much, maybe eight or ten cups a day!” This much tea will not help the gut, let me guarantee you. MSG (Monosodium Glutamate) can also be a stomach irritant in some individuals and is found in many foodstuffs, from Chinese food, crisps and many ready made sauces.
  • Mixing certain foods at the same meal - The Hay diet also known as the Combination diet has helped many people with IBS (though not everyone). The main principles are to eat sweet things separately or before main meals, to eat melon always on it’s own and most importantly to avoid Proteins and Carbohydrates at the same sitting. It also recommends common sense tactics such as chewing well, not eating when stressed and avoiding liquids with or after meals. More information can be obtained by reading one of the many Food Combining books on the market.
  • Age - declining muscle tone - As one gets older, muscle tone naturally gets more relaxed and constipation is quite common. Often gentle exercise such as walking, swimming and gardening and eating dried fruits and diluted fruit juices can help.
  • Spinal misalignment - According to Chiropractors and Osteopaths spinal misalignment can often cause the bowels to work less efficiently. Back pain is often a sign, especially in the lower back or around the pelvis region. One of the worst habits is to cross the legs and over time this can lead to spinal misalignment. Visiting a back specialist can often help chronic cases of bowel problems.
  • Diarrhoea, constipation or even improper blood flow can often cause Piles - However piles can often cause the vicious circle of avoiding defecating because the pain is too much, leading to a greater tendency to further bowel problems.
  • Side effect of other chronic disorders - People taking Chemotherapy often suffer from diarrhoea and less often constipation. People with cancer; especially if it affects the digestive organs can suffer from IBS. Depression often causes a slowing of the body systems, leading to constipation. Anxiety and stress leads to speeding up of body systems often leading to diarrhoea. Diverticular disease is often very serious in individuals. This is where small pouches of intestinal lining protrude outwards causing pockets to be created, where food can lodge and ferment and carry billions of unhealthy bacteria. It is often caused by a western diet of too much protein and not enough fibre in the diet. Diverticular disease often causes constipation and is only serious when the pouches become inflamed and infected causing fever, abdominal pain and constipation and is then known as diverticulitis. IBS can also be a sign of pancreatic disease or thyroid disorder. Tests can be taken by the doctor to rule serious conditions out.
  • Genetic tendency - Some people have a genetic tendency to sensitive intestinal muscles or diverticular pouches. This genetic tendency can be avoided by following the ten steps recommended below for healthy bowels.
  • Hormones imbalance - Some woman find that at certain stages of their menstrual cycle they may be more prone to constipation and diarrhoea. For example a woman may be constipated a few days before menstruation only to have diarrhoea for the first day or two of bleeding. Here treatment would be to balance hormones, increase circulation to the pelvic region (example sitz baths, yoga and aerobic exercise). Chronic constipation can also lead to hormones being reabsorbed into the bloodstream leading to hormonal imbalance, therefore must always make sure the bowels are in perfect working order. PMS is often related to IBS because of this fact. Other woman find hormone treatments such as the contraceptive pill, can lead to IBS either due to direct influence of hormones or due to a greater demand for healthy bacteria which are not being met. (The contraceptive pill has shown to reduce healthy bacteria in the gut).
  • Recreational drugs - Drugs such as cannabis, amphetamines, LSD can sometimes trigger off IBS in those who were already prone to it. Long term use of many stimulant drugs will in time affect the peristalsis of the intestines.

Other causes of IBS are lack of routine, lack of sleep, irregular habits and simply not listening to what the body needs at any given time. Health especially in the intestines is often one of awareness as the involuntary muscles are often affected by emotions. Constipation is often caused by a fear of letting go, of trusting in the universe. Diarrhoea is often caused by fear and anxiety and wishing a situation would go away. Indigestion is caused by stress while cramping is often a holding of mental energy in a particular area of conflict in the body - such as the shoulders (responsibility) or pelvis (identity and understanding needs and wants). IBS can be an invitation to get to know yourself better, your limitations, needs and desires and can also be a tool of awareness to the body.

When you read the amount of trigger of IBS, you will understand how important it is to find the cause. Changing your diet, stress reduction, excercise increase and visiting a natural health practitioner can help make changes in your life in a short period of time. Its simply your “guts” telling you what you need to do, to be more balanced in life!