How I Treat Irritable Bowel Syndrome

How I Treat Irritable Bowel Syndrome

What is Irritable Bowel Syndrome?

Irritable bowel syndrome (IBS) is the name given to a disorder of the muscular walls of the bowel. It is a disorder of the digestive system. It affects gut motility - the rate at which the contents of the bowel are pushed long the rectum.

With research at the Central Middlesex Hospital, it is now established that three types of IBS can be identified.

1. Spastic colon.

Patients with this condition experience lower abdominal pain - pain with the passage of stools, distension, sometimes frequency of bowel movements or constipation. Spastic colon is chronic and debilitating. Although the condition is not life threatening, it drastically reduces the quality of life.

2. Functional diarrhoea.

Patients have frequency and urgency - several stools in rapid succession. People very often become housebound.

3. Foregut motility disorder.

It is the primary motility disorder of the foregut and is particularly distressing to women. It is fight-sided with profound abdominal bloating. Patients are very full after meals and this applies even to the least food intake.

IBS is also known by other names - mucous colitis, spastic colon or non-inflammatory bowel disease. I like to explain IBS as irritable bowel, irritable brain, and irritable body. In the past, the diagnosis of spastic colon was made when other more serious disorders of the bowel had been excluded such as Crohn's disease, ulcerative colitis, diverticulitis, coeliac disease, carcinoma etc. However, IBS is now a recognised stomach disorder.

Who suffers with this condition?

This condition affects all age groups, from the little infant, who cries with a colic pain, to the aged. Research shows that the young and the middle-aged are particularly susceptible to IBS. It is twice as common in women, between the ages of 20-50, than in men of similar ages. Children too are badly affected with IBS, often due to bad potty-training, fear of passing stools due to pain, etc.

Recent research at the Central Middlesex Hospital shows that the reasons for this condition to be common in women in this specific group are:

More women contact their doctors about IBS symptoms.
IBS is connected with diet. Diet is of greater interest to women than to men.
Depression and anxiety are twice as common in women, IBS researchers Dr. Gerald Libby and Dr. Jennifer Gomberon (Middlesex Hospital) point out that women are more emotional than men.
Women's perception of the illness, and their pain, discomfort and tolerance levels. It is likely that women perceive internal events in the abdomen differently from men and that they may be more focused on these events.
The gut is more sensitive to various stimuli in women than in men. In an important study from the U.S.A. (1993), Potter & colleagues found in `fibre intake trials' that the whole gut transit time was significantly slower in women than men. Women are less tolerant, for example, of a bloated or distended stomach.
IBS symptoms are worse at menstruation, pregnancy and childbirth.
Sexual intercourse can also be painful, and urinary problems also occur.
You may be interested to know that, in the Indian sub-continent, IBS is more common in men. Men seem to seek more medical advice for this condition.

What are the symptoms of IBS?

Abdominal pain - usually low down on the left side but, sometimes, in the middle or on the right.
Constipation, with or without stomach pains.
Diarrhoea, with or without stomach pains.
Bloated feelings in stomach or distended with much flatus (wind)
Passing mucus in stools, or by itself
Incontinence.
Small ribbons or pebble-like bowel movements.
Rectal discomfort, never feeling the rectum is completely clear.
Poor appetite, weight loss, anorexia.
Wanting to eat things frequently (bingeing).
Tightness around the waist.
Headaches.
Backache.
Depression and anxiety.
Difficulty in bending down.
Menstruation problems.
Painful intercourse.
Secondary symptoms

Breathing problems.
Rashes.
Flushing.
Aching joints.
Fatigue.
Sore mouth, burning tongue.
Frequent cystitis.
Raw feeling in the gullet.
Fluid retention.
Insomnia.
Tachycardia or bradycardia. (rapid or slow pulse)
So many patients have so many symptoms that it is a matter of luck whether they are referred to a gastroenterologist, and are correctly diagnosed as having IBS or, for example, they are investigated by a cardiologist or gynaecologist.

I never assume that my patient is just suffering with IBS. They could be having genuine urinary problems or gynaecological problems etc. Together with their IBS problems these symptoms must be investigated fully.

What causes IBS?

Long courses of antibiotics, which may upset the natural balance of bacteria in the body, or other drugs.
Viral infections.
Operations - usually on the pelvic region, or hysterectomy and abdominal operations.
Diet - a very difficult one to deal with.
There is no set diet for IBS as it is necessary to do a food intolerance test. Examine what your patient eats. You can see by the nature of their diet how it affects their bowel. Taking more bran can, in fact, cause a lot of pain if the person is intolerant of it etc.

5. Abuse of alcohol.
6. Caffeine.
7. Food allergies/intolerances.
The most common are onions, cabbage, orange juice, molasses, wheat, yeast, corn and dairy products.

8. Overeating.
9. Hormone problems - low thyroxine levels.
10. Obesity.
11. Gall bladder problems.
12. Lack of exercise.
13. Oversensitivity of the bowel muscle which is, perhaps, inherited.
14. Intestinal candidias.
There are two forms. One, which is well known for causing oral thrush or vaginal thrush. Intestinal candidias is a dangerous fungus or parasite which puts down little roots called (rhizones) into the smooth surface of the intestinal tract, ie. the mucous membrane.

15. Leaking gut.

Briefly, in this condition, the lining of the gut becomes permeable which means that large molecules of incompletely digested food protein, yeast by-products and toxins are able to penetrate into the blood stream, thus provoking responses from the immune system. In the healthy body, these `holes' are small enough to stop contaminated molecules from entering the blood stream and causing harm. If the gut is leaking, it means that the barrier is broken and the toxins are released into the blood stream.

You can suspect a leaking gut if you have problems like abdominal pain, abdominal distension, diarrhoea, food intolerances, fevers of unknown origin, muscle pain, joint pains, fatigue and malaise, skin rashes, cognitive and memory deficits, shortness of breath and poor exercise tolerance.

A leaking gut is usually caused by exposure to substances which damage the lining of the intestines. The commonest causes of damage are candida albicans, infestious agents (viral, bacterial & protozoan (single-celled organisms which cause diseases like malaria, amoebic dysentery etc.), alcohol, non-steroidal anti-inflammatory drugs (NSAIDS), open heart surgery, shocks etc.

16. Psychological problems.

Most doctors would agree that psychological problems do affect some IBS sufferers. We must, therefore, conclude that the mental state of the patient and their IBS symptoms are closely intertwined, and these two different aspects may be difficult to separate.

The neuroanatologists and neurophysiologists have termed this the `enteric nervous system'. The intestines supply the brain with messages via what is termed `afferent' nerves and, in turn, receive messages via what is termed `efferent' component of the interconnecting autonomic nervous system. IBS researchers, as a consequence of these discoveries, are now thinking of a concept called the `brain-gut axis' - the interrelationship between the central nervous system and brain function and the function of the intestines or gut. We can, therefore, no longer disregard or ignore the fact that depression, anxieties, sexual, physical, emotional and verbal abuse, stress and deep-rooted psychological problems could not only be `effects' of severe long-standing IBS, but could actually be causing IBS.

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17. One area which I, personally, have found to cause IBS, is internal scar tissue after abdominal operations.

Homoeopathically, I find a combination of Thiosinaminum and Graphites 12c, three times a day, for about 3 weeks will be sufficient to clear the scar tissue.

Fortunately, there is now a new way of stopping scar tissue with a bioresorbable membrane. It is called `sepra' film. Many surgeons will now re-open old wounds and use the sepra film. In the past, many surgeons refused to re-operate on the basis that there would be worsening of the scar tissue.

Food intolerances

I find food intolerances are very high on the list of IBS sufferers. No two people are alike and there is no single best diet for IBS. Very often, hospitals recommend patients to add a high intake of bran to their diet. Sadly, this could be the most damaging thing they could do. Bran fibre is particularly irritating to the gut lining.

There are studies to show that coarse wheat-bran can increase the pain and urgency to pass stools (`Gut' 1994). Very few people are interested in having the problem treated; they prefer to self-medicate instead of seeking professional help. Advised by friends, media and articles of IBS, they resort to eliminating many foods, some quite unnecessarily, soon running into nutrition problems or anorexia. Invariably, they continue to eat more of their poison, as they have very little else left to eat. It is always necessary to pinpoint one's own poison.

It is also necessary to work through with each individual as to how they should eat - no large meals, no fry-ups, no fats, etc. There are many vegetables, by the very nature of what they are, that contribute to wind and bloating. These are chick peas, peanuts, cabbage, cucumber, bran cereal, kidney beans, pulses, carrots, onions, muesli, lentils, broccoli, cauliflower, lettuce and baked beans. There are numerous ways to check for intolerances - cytotoxic, rast, vega testing, applied kineseology, elimination diets etc. There are many labs offering their services but make sure that you choose a reputable one.

The Treatment of IBS

Frankly, conventional medicine has very little to offer. Constipation can usually be treated quite simply with extra fibre in the diet, fruits cereals, vegetables. Be warned, fibre can be the main culprit as the patient could be intolerant to bran, wheat etc. Psyllinum husks mixed with oat bran is gentle. Ginger capsules help with wind and colic.

In my many years of dealing with IBS, I am able to obtain a higher rate of success when I use a combination of hypnotherapy and homoeopathy compared to homoeopathic medicine only. In addition, an elimination diet or intolerance test is required as many patients do in fact have allergies and food intolerances.

I have already explained the relationship of the gut/brain under psychological causes. In recent research, at the Middlesex Hospital and the Mayo clinic USA in 1992, it was found that a very large percentage of IBS sufferers had undergone sexual, physical, emotional and verbal abuse. This finding was not new to me and I do agree with their findings. However, this does not imply that all IBS patients had such abuses, and I must emphasize here that we will be doing our IBS patients a lot of disservice to stigmatize them all with this label.

IBS patients are severely affected by their occupations, responsibilities, financial worries, emotional problems, relationship problems, anxiety, depression, traumas, and so on. We now know the importance of the psychological side in IBS.

British Homoeopathic Association (BHA).

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By Julie Allen

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