Conditions

Irritable Bowel Syndrome/IBS

Irritable bowel syndrome (also known as intestinal neurosis, mucous colitis, spastic colitis, or spastic colon) occurs when normally rhythmic muscular contractions of the digestive tract become irregular and uncoordinated. This interferes with the normal movement of food and waste material, and leads to the accumulation of mucus and toxins in the intestine.

The accumulated material sets up a partial obstruction of the digestive tract, trapping gas and stools. IBS may affect the entire gastrointestinal tract. There are no physical signs of the disease in the bowel tissue with this disorder, and its cause is unknown.

Whether or not an individual with IBS eats normally, malnutrition may result because nutrients often are not absorbed properly. As a result, people with IBS require as much as 30% more protein than normal, as well as an increased intake of minerals and trace elements, which can quickly be depleted by diarrhea.

Signs and Symptoms:

• Crampy pain in the lower abdomen
• Bloating
• Gassiness
• Changes in bowel habits
• Diarrhea or constipation, or both alternately
• Need for bowel movement immediately on waking or after eating
• Relief of pain after bowel movement
• Feeling of incomplete emptying after bowel movement
• Mucus in feces

Diagnosis:

Your doctor will likely perform a physical examination and review of the symptoms. He or she may also perform a rectal examination and may order any of the following tests and imaging procedures:

• A stool sample, preferably a three-day slide series, can reveal the presence of blood, ova, parasites or bacteria.
• Biochemical profiling, including serum amylase, and urinalysis, also serves to narrow the diagnosis-ESR, CBC.
• Abdominal ultrasound
• Barium enema X-ray
• X-rays of the small bowel or the upper gastrointestinal tract
• Colonoscopy can also help to rule out organic causes of IBS-like symptoms.

Treatment Options:

There is no clinically effective treatment for irritable bowel syndrome except to avoid those foods (and stresses) that may trigger an episode of IBS. Your doctor may treat your symptoms in a variety of ways, however.

Traditional Treatments:

• For frequent diarrhea, loperamide (found in Imodium AD and other products) may be recommended. Loperamide slows the movement of the digestive tract, allowing more time for reabsorption of water and electrolytes from the stool. This drug is often prescribed for chronic diarrhea. However, you should not use it if you have a fever over 101oF, or if you have bloody stools.
  And drug called hyoscyamine may be prescribed in some cases, either on its own or in a combination formula that includes a mild tranquilizer. These preparations reduce spasms and cramping by inhibiting the action of the nerves that stimulate the muscles of the stomach and intestines to contract. Other drugs in this class are dicyclomine and propantheline.
• Fiber products such as psyllium, bran, or methylcellulose can be used if constipation is a problem. If this is not successful, a gastrointestinal stimulant such as cisapride (Propulsid) may be tried.
• Your doctor may recommend trying a tricyclic antidepressant if he or she feels that a psychological disturbance may be involved in your condition.

Complementary and Alternative Therapies:

Irritable bowel syndrome can often be successfully treated with alternative therapies. Most important are proper eating habits, stress reduction, and gastrointestinal support. Incorporating nutritional supplements may help reduce the effects of stress. Chronic IBS may also benefit from digestive enzymes. Stress reduction techniques can help patients to deal with stress related factors.

Nutritional Supplementation:

• Take digestive enzymes with meals (follow label directions) to help ensure full absorption.
• Take a good multivitamin and mineral supplement daily.
• Probiotic supplements can help restore "friendly" bacteria to the digestive tract. Take a probiotic supplement as recommended on the product label.
• Fiber has both a healing and cleansing effect on the intestinal tract, and also promotes efficient bowel action. Choose a fiber supplement such as psyllium seeds, flaxseeds, guar gum, or oat bran, and follow the label directions. Flaxseeds have the additional advantage of providing the essential fatty acids that help protect the intestinal lining.
• The amino acid glutamine helps to soothe the digestive tract, and is often beneficial for inflammatory bowel disorders such as IBS. Take 500 mg of L-glutamine three times daily for two weeks, then decrease to 500 mg twice daily for two weeks. Then take 500 mg daily for two months.
• Magnesium and calcium are important to the central nervous system, and help soothe a nervous stomach and irritated bowel. Take 500 mg of calcium and 250 mg of magnesium twice a day.
• The B vitamins are needed for a healthy intestinal tract, including the efficient absorption of proteins, carbohydrates, and fats. Take a good B-vitamin complex that supplies 50 mg of each of the major B vitamins.
• Essential fatty acids are needed to protect the intestinal lining. Flaxseed oil and primrose oil are good sources.

Alternative Therapies:

• Alfalfa contains vitamin K, needed to build intestinal flora for proper digestion, and chlorophyll for healing and cleansing of the bloodstream.
• Aloe vera is healing to the digestive tract.
• Peppermint aids in healing and digestion, and also relieves upset stomach and gas. It must be taken in enteric-coated capsule form to prevent the oil from being released before it reaches the colon. Heartburn may result with any other form.
• Skullcap and valerian root are helpful for the nerves that regulate intestinal muscle function.
• Other herbs that can be beneficial for IBS include balm, chamomile, fenugreek, ginger, goldenseal, lobelia, marshmallow, pau d'arco, rose hips, and slippery elm.
  Warning: Do not use chamomile or lobelia on an ongoing basis. Avoid chamomile completely if you are allergic to ragweed. Do not take goldenseal internally on a daily basis for more than one week at a time. Do not use goldenseal in large quantities during pregnancy, and use goldenseal with caution if you are allergic to ragweed.
• Chinese (Korean) ginseng can decrease sensitivity to stress, a common factor in IBS.
  Warning: Do not use ginseng if you have high blood pressure, heart disease, or hypoglycemia.
• Ginger has beneficial effects on the entire gastrointestinal tract, and is famous for relieving nausea.
• Mild thistle contains silymarin, which is highly beneficial to the liver. A sluggish liver contributes to digestive disturbances.
• Turmeric is full of active bioflavonoids that are effective in relieving inflammation.
• The homeopathic remedies Argentum nitiricum and Nux vomica may be helpful for IBS. Contact your local homeopathic practitioner for a constitutional remedy.
• The accupresure points Gallbladder 34, Large Intestine 10, Liver 3, Pericardium 6, Small Intestine 5, and Stomach 36 may help with IBS.

General Recommendations:

• Work to reduce the effects of stress, both physically and mentally.
• Get regular exercise.
• Eat a high-fiber diet
• Limit your consumption of gas-producing foods.
• When an intestinal upset occurs, switch to a bland diet.
• Use charcoal tablets to relieve occasional gas and bloating.
• Check for food allergies.
• Chew your food well.
• Wear loose-fitting clothing.
• Do not eat right before going to bed.

Warnings:

• Do not use chamomile or lobelia on an ongoing basis.
• Avoid chamomile completely if you are allergic to ragweed.
• Do not take goldenseal internally on a daily basis for more than one week at a time.
• Do not use goldenseal in large quantities during pregnancy.
• Use goldenseal with caution if you are allergic to ragweed.
• Do not use ginseng if you have high blood pressure, heart disease, or hypoglycemia.