How to Control Irritable Bowel Syndrome

April is Irritable Bowel Syndrome (IBS) Awareness month. We wanted to share some information about IBS as well as a few ideas about how to control it.

It is estimated that between 25 and 45 million Americans are diagnosed with IBS, according to the International Foundation for Functional Gastrointestinal Disorders, Milwaukee, Wisconsin.  Of these, 2 out of 3 are women. Worldwide, the disease affects between 9 and 23% of the population.

Although symptoms are uncomfortable, IBS–unlike ulcerative colitis and Crohn’s disease–which are forms of inflammatory bowel disease–does not  cause changes in bowel disease or an increased risk of colon cancer, explained The Mayo Clinic, Rochester, Minnesota. “Some of the patients can control their symptoms by managing diet, lifestyle, and stress, while others may need medication,” the Clinic added.

What Are the Symptoms?

While the signs and symptoms of IBS can vary from person to person, and resemble other gastrointestinal issues, these are the most common signs:

1.  Abdominal pains or cramping.

2.  A bloated feeling.

3.  Gas.

4.  Diarrhea or constipation or an alternating bout of each.

5.  Mucous in the stool.

6.  Rectal bleeding.

7.  Weight loss.

What Are the Common Triggers?

1. Foods.  The role of food allergies or intolerance in IBS is still being investigated, but certain foods can trigger a response. These include chocolate, spices, fats, fruits, beans, cabbage, cauliflower, broccoli, milk, carbonated beverages, and alcohol.

2.  Stress.  Many patients with IBS find their symptoms are more frequent during extreme stress.

3.  Hormones.  Since women are more prone to the disease, researchers believe that hormones play a key role, such as during menstrual periods.

“If you have persistent changes in bowel habits, or if you have other signs of IBS, it is important to confer with your doctor, since these symptoms may indicate a more serious condition, such as colon cancer,” the Clinic continued.

What Are the Causes?

Abnormalities in your gastrointestinal nervous system may cause you to experience greater than normal discomfort, such as when your abdomen stretches from gas or stool.  Problems that don’t bother others can trigger a response in those with IBS.

Other illnesses, such as an episode of infectious diarrhea–gastroenteritis–or a bacterial overgrowth in the intestines, can trigger a bout with IBS.

What Are the Risk Factors:

1.  Under the age of 45.

2.  About twice as many women as men have the disease.

3.  A family history of the disease.

4.  Anxiety, depression, a personality disorder, or a history of childhood sexual abuse are risk factors.

5.  For women, domestic abuse may be a factor.

6.  Diarrhea and constipation can aggravate hemorrhoids.

7.  Having IBS can complicate your quality of life, which can lead to discouragement and depression.

What About Alternative Medicine?

While doctors prescribe drugs, hypnotherapy, etc., for the treatment of IBS, your doctor may recommend a variety of alternative medicine therapies, which are showing promise in dealing with this complicated disease.

Based on a study by The British Journal of Nutrition adding more healthy and functional foods, such as KAMUT® khorasan ancient wheat and eliminating modern wheat from your diet can assist with some of the symptom of IBS.

Writing in the World Journal of Gastroenterology, Oliver Grundmann, M.D., of the University of Florida in Gainesville, said that he and other doctors propose an integrative approach in treating the diverse symptoms of IBS by combining the benefits and need for pharmacology with known complementary and alternative medicine (CAM) therapies, to provide IBS patients with the best treatment outcomes available.

Initial steps in this direction, he continued, are already being considered, with an increasing number of practitioners are recommending CAM therapies if pharmacotherapy alone does not alleviate symptoms sufficiently.

A number of studies have suggested that enteric-coated peppermint oil may be effective in relieving some of the symptoms of IBS, reported B. Klingler, M.D., of Albert Einstein College of Medicine in New York.

The oil is well tolerated at the commonly recommended dosage, but there may be significant adverse effects at higher dosages, he said.

Some patients with IBS experience an association between symptoms and food consumption, reported Solveig C. Ligaarden, M.D., et al., at Innlandet Hospital in Njovik, Norway.  They also found low intakes of vitamin B6 can exacerbate the symptoms of IBS. In their study, they found the participants were ingesting 0.9 mg/day of the vitamin, when the recommendation is 1.6 mg/day or more.

At the University of Sheffield in the United Kingdom, a research team headed by S. F. Sprake, M.D., brought relief to a 41-year-old woman with IBS by prescribing vitamin D3.  In interviewing 37 patients with IBS, who had been prescribed this therapy, 70% reported that the vitamin brought relief from their symptoms.

Since some strains of probiotics reportedly exert remarkable therapeutic effects, Kyoung Sup Hong, M.D., et al., at Seoul National University in South Korea, designed their study to assess these effects in Korean adults with IBS.

In the study, 36 and 34 patients were randomized to probiotic and placebo groups for 8 weeks.

They reported that composite probiotics containing Bifidobacterium bifidum and Lactobacillus acidophilus, and other strains, are safe and effective, especially with patients who excrete normal or loose stools.

Researchers at McMaster University in Hamilton, Ont., Canada, found that fiber, antispasmodics, and peppermint oil were more effective in treating IBS than the placebo.

While the exact mechanisms of how probiotics help patients with IBS are unknown, they apparently are involved with alterations in gut bacteria, reported George Aragon, M.D., et al., of George Washington University in Washington, D.C.  Their review in Gastroenterology and Hepatology focuses on recent studies examining the role of probiotics in the treatment of IBS.

References:

            “Irritable Bowel Syndrome,” The Mayo Clinic, Rochester, Minn., 2015.

`           Grundmann, Oliver, M.D., et al.  “Complementary and Alternative Medicine in IBS: An Integrative Review,.” World Journal of Gastroenterology 20(2):346-362, Jan. 2014.

            Klingler, S., M.D., et al.  “Peppermint Oil,” American Family Physician 75(7):1027-1030, Apr. 2007.

            Ligaarden, Solveig C., M.D., et al.  “Low Intake of Vitamin B6 Is Associated with IBS Symptoms,” Nutrition Reviews 5:356-361, May 2011.

            Sprake, E. F., M.D., et al.  “Vitamin D3 As a Novel  Treatment for IBS: Simple Case Leads to Critical Analysis of Patient-Centered Data,” British Medical Journal Case Report, Dec. 13, 2012.

            Ford, Alexander C., M.D., et al.  “Effect of Fibre, Antispasmodics, and Peppermint Oil in the Treatment of IBS: A Systematic Review and Meta-Analysis,” British Medical Journal 337:2313, Nov. 2008.

            Hong, Kyoung Sup., M.D., et al.  “Effect of Probiotics on Symptoms in Korean Adults with IBS,” Gut and Liver 3(2):101-107, June 2009.

            Aragon, George, M.D., et al. “Probiotic Therapy for IBS,” Gastroenterology and Hepatology 6(1)39-44. Jan. 2010.