Treating Irritable Bowel Syndrome
By Bonnie Jenkins, Advanced Natural Medicine Bulletin
Irritable bowel syndrome (IBS) – it affects up to 20 percent of Americans, including yours truly. And I can tell you, it’s no picnic. Symptoms can range from inconvenient to downright debilitating and can include abdominal cramping, bloating, gas, and either constipation or diarrhea.
The biggest problem though, is that no one really knows what causes IBS. Some think it is triggered by stress; others are convinced that IBS is caused by an imbalance in the body’s digestive tract. There’s another camp that believes food allergies are at the root of IBS. And, since doctors and researchers can’t agree on its cause, modern medicine has little to offer for its cure.
Diagnosing IBS is also problematic because there isn’t a test that can give doctors a definitive diagnosis. Instead, health care providers start eliminating the possibility of more easily diagnosed inflammatory bowel problems like celiac disease, ulcerative colitis, and Crohn’s disease. Once your doctor is sure you don’t have any of these other problems, he or she may settle on IBS.
Get Better With Bugs
IBS may strike because “good” gut bacteria becomes overwhelmed by “bad” bugs – which can be the result of taking antibiotics. Antibiotics are designed to kill off disease-causing bacteria, but they don’t discriminate. Along with killing the bad, antibiotics also destroy good bacteria, essentially leaving you defenseless.
After a course of antibiotics, add a daily probiotic supplement to repopulate the good bacteria. But even if you haven’t taken antibiotics recently, ramping up your probiotics can help prevent flare-ups and soothe digestive disturbances, especially abdominal cramps and bloating.
To maintain beneficial bacteria and support a healthy digestive system, try to eat some type of cultured foods daily, or at least several times a week. Good probiotic-rich foods include kefir and yogurt, sauerkraut and miso. But to ensure that you are getting enough, it’s also a good idea to take a probiotic supplement. Look for a mixture of probiotic strains, in a supplement containing at least four to five billion colony-forming units, twice a day for one to two months. The mix of probiotic bacteria helps alleviate a variety of symptoms. Plus, you may respond to some probiotic strains better than others.
Fill Up With Fiber
Fiber has an odd benefit for anyone with IBS. Not only does it soften the stool and counteract constipation, it also helps if you have IBS with diarrhea. Plus, it helps regulate bowel movement frequency and consistency in between attacks.
While all fiber is good for you – the FDA recommends eating 25 to 35 grams of fiber a day – soluble fiber can be healing for those of us with IBS. In fact, soluble fiber is the single greatest dietary aid for preventing IBS symptoms – as well as relieving them once they occur. But, here’s the kicker. Soluble fiber isn’t typically found in foods most people think of as fiber-rich, like bran or leafy green vegetables. Instead, this special fiber is found in oats, rice, quinoa, barley, soy, root vegetables, avocados, mushrooms, apples, and bananas.
Why is soluble fiber so special? Because unlike any other type of food, soluble fiber soothes and regulates the digestive tract, stabilizes the intestinal contractions resulting from the gastrocolic reflex, and normalizes bowel function. Nothing else in the world will do this for you.
Here’s how it works: Soluble fiber dissolves in water. This allows it to absorb excess liquid in the colon, preventing diarrhea by forming a thick gel and adding a great deal of bulk as it passes intact through the gut. Soluble fiber also softens the stool, making it easier to pass in people who suffer from constipation.
While it’s best to include several servings of soluble fiber in your diet every day, that’s not always possible. Luckily, you can augment the amount of dietary fiber you are eating with psyllium supplements. You can find these supplements as either a powder that is mixed with water, capsules, or chewable tablets. It is best to follow label instructions on psyllium supplements. Just be aware that it’s important to drink lots of water. Without water, psyllium can’t expand and work its digestive magic.
The Peppermint Twist
Peppermint has become a popular herb among those with IBS. And no wonder – carminative herbs like peppermint relieve IBS-related cramps, gas, and bloating. Peppermint normalizes the flow of minerals, such as potassium and sodium, in the smooth muscles of the intestines so they contract and release in a normal way, not spasmodically. This herb works so well that, in a recent double-blind study of 57 people with IBS, those treated with two enteric-coated peppermint capsules twice daily for four weeks reported that their symptoms were 50 percent less severe.
To prevent cramping after a meal, drink a strong cup of peppermint tea. If you tend to get heartburn, tread carefully since peppermint can make acid reflux worse. Instead, take 0.2 to 0.4 ml of peppermint oil in enteric-coated capsules three times daily. The coating prevents peppermint from releasing until it reaches the small intestines, where IBS sufferers need it most.
One Last Thing …
People who suffer from IBS often have food intolerances, too. So, the first step in addressing symptoms is often an elimination diet. During an elimination diet, suspect foods are avoided and then reintroduced one at a time to see if a particular food or food group makes your symptoms worse. Sixty to 70 percent of people who follow an elimination diet find that a certain food is contributing to their IBS.
An elimination diet usually lasts for two to four weeks, during which time you stop eating the most common irritation culprits: soy, dairy, citrus, wheat, and nuts. You can also try eliminating other foods that you eat frequently or tend to crave. These may cause IBS symptoms, too.
If your symptoms don’t improve during the elimination period, you may not have a dietary IBS trigger. But if you find relief, challenge yourself by reintroducing one food at a time for three to four days, noting how your body reacts. If you suffer a bout of IBS, take the food back out of your diet. If you feel fine, leave the food in your diet. Then progress to the next test food.
Research Brief …
As we settle into the gloomy days of winter, people with depression sometimes feel particularly blue. But help may be as simple as trying St. John’s wort. New research confirms that this herb works for people with mild to moderate disorders. In fact, it may be just as effective as antidepressants – and cause significantly fewer side effects.
In a recent review, researchers compared St. John’s wort with both standard antidepressants and a placebo. The review included 29 trials and a total of 5,489 participants – all of whom were assessed before and after treatment. In the majority of studies reviewed, the herb was better than the placebo for the symptoms of depression and just as effective as the prescription antidepressants.
Of course, St. John’s wort isn’t a miracle “happy” pill that will make all of your cares go away. But it can be highly effective when combined with other therapeutic actions.
Here are some other things you can do if you or someone close to you feels depressed:
• Seek help. If you think you might be depressed, see your health care provider or a counselor. If you feel suicidal, contact a suicide hotline immediately.
Yours in health and happiness,
Cappello G, Spezzaferro M, Grossi L, et al. “Peppermint oil (Mintoil) in the treatment of irritable bowel syndrome: a prospective double blind placebo-controlled randomized trial.” Digestive and Liver Disease. 2007;39:530-536.
Ford AC, Talley NJ, Spiegel BM, et al. “Effect of fibre, antispasmodics, and peppermint oil in the treatment of irritable bowel syndrome: systematic review and meta-analysis.” British Medical Journal. 2008;337:a2313.
Linde K, Berner MM, Kriston L. “St. John's wort for major depression.” Cochrane Database of Systematic Reviews 2008; 4: CD000448.
Williams E, Stimpson J, Wang D, et al. “Clinical trial: a multistrain probiotic preparation significantly reduces symptoms of irritable bowel syndrome in a double-blind placebo-controlled study.” Alimentary Pharmacology & Therapeutics. 2008 Sep 10. [Epub ahead of print]