Melbourne Holistic Health Group

Published in Articles - Digestive Health on 31 October 2011 by Melbourne Holistic Health Group

Irritable bowel syndrome (IBS) is a common complaint that our naturopathic practitioners see at the clinic. While IBS can occur at any age, it often begins in early adulthood and is twice as common in women as in men. Patients who suffer from IBS will usually report symptoms of abdominal pain and cramping, bloating, flatulence, constipation or diarrhoea. People with IBS may switch between constipation and diarrhoea, or mostly have one or the other. Other symptoms may include the presence of mucus in the stools, sensations of incomplete evacuation, sense of straining or urgency on the toilet, as well as nausea and fatigue. These symptoms may vary from person to person, and range from mild to severe. Many of the symptoms of IBS, such as abdominal pain and bloating, will often go away after a bowel movement or after passing wind. For some people these gut symptoms may get better for a period of time and then return, while for others they may be present most of the time. In many ways the bowel is ‘irritable’, and normal digestive function is disturbed which often causes significant discomfort and impacts on quality of life.

Diagnosing IBS

It wasn’t until the late 70’s and early 80’s, that the medical community accepted IBS as a serious disorder and not just a psychosomatic problem. IBS used to be considered a diagnosis of exclusion, in that when more serious disease conditions or pathology were ruled out, a diagnosis of IBS was made. While more serious causes of abdominal pain and irregular bowel function should always be ruled out first, IBS has now been recognised as a condition with its own diagnostic criteria as set out by the ‘Rome II Criteria for IBS’. Your naturopath will be able to guide you as to which investigations may be necessary, and assess risk factors for any other possible causes of irregular bowel function.

What causes IBS?

While the causes of irritable bowel syndrome are still largely unknown, the available research suggests that there is not one causative factor, but rather the development and progression, as well as the triggers for IBS are multi-factorial. In the past motility disorders, which involve the abnormal movement of the gastrointestinal tract were considered the essential cause of IBS. More and more so, disorders of the enteric nervous system (the nerves which innervate the gut) are seen as the key factor.

Some of the underlying causes and/or triggers of IBS include:

• Psychological and emotional stress – Stress and anxiety often have a significant impact on the enteric nervous system (nerves of the bowel). Dysregulation of the enteric nervous system and a heightened or hypersensitive response to stress is recognised in medical literature as a key factor in IBS development. Most sufferers of IBS recognise that stress is a key trigger for exacerbations of symptoms.

• Infection – Infection (such as bacterial, viral or parasitic infection of the gut) may cause inflammation to the bowel which affects normal bowel function. Following an episode of infection there may be changes to the nerve function in the bowel, inflammation as well as alterations in the normal bacterial population of the bowel. This can lead to bowel symptoms characteristic of IBS despite the fact that the pathogenic parasite, bacteria or virus has been eliminated.

• Changes to bowel flora – There are numerous dietary and lifestyle behaviours which can negatively impact on the microflora of the bowel. Stress, poor dietary habits, low fibre and antibiotic use as well as other medications are known to result in dysbiosis (altered bowel flora). Dysbiosis can significantly worsen symptoms of bloating and flatulence seen commonly in sufferers of IBS.

• Food intolerance – There may be a number of foods which trigger IBS. Identifying the triggers will often require the help of a skilled practitioner. Impaired absorption of sugars such as lactose (found in dairy) and fructose (present in many fruits), as well as wheat and gluten are often seen to trigger IBS symptoms, however triggers do vary from person to person.

• General diet and lifestyle – Depending on the specific symptoms of IBS, there may be dietary triggers which worsen symptoms (such as low fibre intake for constipation-dominant IBS), the quality of food in the diet as well as meal regularity are also important factors in helping to control symptoms and possibly address causes. Lifestyle factors such as lack of exercise can also impact on bowel tone and frequency as well as recurrence of IBS symptoms.

How can your naturopath help you?

Given that there are a variety of causes and triggers of IBS symptoms, your naturopath is perfectly placed to assist you in providing a comprehensive analysis and treatment advice. This will include advice on whether your symptoms will require further investigation. Treatments may include herbal and nutritional supplementation, as well as lifestyle strategies for stress management, dietary investigation for food intolerances, specific strain probiotic supplementation for dysbiosis, as well as meal planning and dietary advice to regulate and support healthy bowel function. Many patients we see at the clinic experience significant, if not full recovery from IBS.

Other articles on IBS:

• Irritable Bowel Syndrome and Food 
• Irritable Bowel Syndrome and Stress 
• Irritable Bowel Syndrome and Probiotics
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