Irritable bowel syndrome (IBS) is really a catch-all term for any bowel discomfort that doesn’t fit into other recognised bowel diseases such as ulcerative colitis or diverticulitis. There is no clinical test that can confirm IBS – rather the term encompasses a wide range of symptoms, the most common of which are abdominal cramping and pain, constipation, diarrhoea, wind and loose stools.
IBS is a common condition and one that responds well to nutritional therapy. This is because nutritional therapy places great emphasis on gut health. Our body needs a wide range of nutrients, but these nutrients need to be digested and absorbed, and unwanted matter eliminated. The ‘irritable’ in IBS implies that there is a dysfunction somewhere in the gastro-intestinal (GI) tract (which runs from the mouth to the anus), and the health of the gut needs to be addressed if the body as a whole is not to suffer from lack of nutrients and a build-up of toxic waste.
It is important to remember that the health of the GI tract is of additional importance because it helps to prevent harmful pathogens from entering the body.
IBS may develop for several possible reasons, the most common being poor digestion, gut dysbiosis or infection, and food intolerance. It is probably easiest to understand the possible problem areas by working our way down the gut.
There are four organs that are key to good digestion – the stomach, pancreas, liver and intestines. In an ideal situation, they work together to break down foods efficiently so that nutrients can be absorbed into the body, but any weakness in any of these organs can result in foods not being properly digested and absorbed.
Acid produced by the stomach is responsible for the first part of the breakdown of proteins, and is also important in liberating minerals (e.g. calcium) so that they can be utilised by the body. Acid production is affected by stress and can be hampered by a zinc deficiency, as zinc plays a part in the chemical reaction in the body that creates the acid. Stomach acid production generally also decreases with age. A reduction in stomach acid also allows bacteria and other infectious agents to survive.
Enzymes are essential to break food down further, and are mainly produced by the pancreas. The term pancreatic insufficiency is used when the pancreas is not producing sufficient enzymes.
Both poor stomach acid production and pancreatic insufficiency lead to inadequate break- down of foods. These foods can ferment in the gut, which is one of the causes of bloating and wind.
Bile is produced by the liver and helps to break down fats. It also gives stools their characteristic dark brown colour.
The intestines are responsible for the absorption of digested foods into the body. The intestines are home to bacteria and often parasites and fungi as well. Some of the bacteria actually help us and are known as good gut bacteria (probiotics). They help keep the bad bacteria at bay and can even manufacture vitamin K and some of the B vitamins. Certain foods (e.g. bananas, oats and onions) contain substances that feed the good bacteria and help keep the gut microflora in balance. Live yoghurt can contain probiotics.
There is an ongoing battle between the bacteria that help the body and those that are harmful. Antibiotics are often a curse to the gut as they disrupt the normal balance of bacteria, enabling pathogenic agents such as Candida albicans (a fungus) to get out of control.
Pathogens such as candida and parasites release toxins that can lead to bloating. They can also damage the gut wall and allow foods to enter the bloodstream before they have been broken down, which is known as leaky gut syndrome. The body will regard these food particles as an unwelcome visitor (antigen) and an immune reaction may take place, leading to puffy eyes, fatigue, a foggy brain and even arthritis. The food that caused this reaction is now toxic to the body, and a food intolerance can develop.
WORKING OUT THE PROBLEM
We have seen that there are several possible causes of IBS: poor stomach, pancreas or liver function, the presence of unfriendly bacteria, fungi or parasites in the gut, and food intolerances.
To a large extent, an analysis of the symptoms can often determine where the problem lies. For example, diarrhoea that recurs on a regular basis suggests the presence of a parasite.
There are laboratories that do detailed digestive function tests, including investigation for parasites, fungal infection or unwanted bacteria, and although these are expensive they can pinpoint a problem that may otherwise be elusive. Too often, for example, people assume they have a candida problem and undergo a highly restricted dietary regimen for months with no improvement, because candida wasn’t the problem in the first place.
Another useful tool is a test to establish whether you have food intolerances. True food allergies are quick to show up, but the more common food intolerances have delayed symptoms, making identification of the food that is causing the problem difficult. Often people experience a marked improvement if they avoid the most common problem foods such as wheat, dairy and citrus, but any food could be a problem and a clinically proven food intolerance test that measures immune reactions to foods can be really useful.
Once the underlying problem has been identified, there are various nutritional solutions on offer.
- Taking lemon juice or digestive bitters can increase stomach acid production.
- Taking digestive bitters or digestive enzymes, which are available as supplements, can also increase the output of digestive enzymes by the pancreas. The hardest meals to digest are those with a high protein content, so it is particularly useful to take digestive enzymes with a braai, for example.
- The liver needs to produce bile, and detoxifying the liver can help to increase bile production. A detox can assist in this process, ensuring that you eat plenty of foods such as broccoli, cabbage, onions, asparagus and spinach. Taking the herbs milk thistle or dandelion can also support liver health.
- Dealing with problems in the intestine is trickier. There are many natural substances that can kill parasites, bacteria and fungi, such as cloves, black walnut, garlic, grapefruit seed ex- tract, olive leaf extract, pau d’arco, oregano oil and caprylic acid. These substances generally leave the good bacteria intact, but it can be a tricky business choosing which ones to take. Ideally you want to know what you are dealing with, and this is where testing can come in useful. Alternatively you can try taking a combination of these antimicrobial agents and see if your symptoms improve. Visit your health shop and ask for a combination product. There are some excellent ones available.
- If there is a problem in the gut, you will almost certainly benefit from a course of probiotics to help improve the number of good bacteria. If your gut wall has been damaged by pathogens, resulting in a leaky gut, you may need to take glutamine, an amino acid that helps to heal the gut wall. The whole process of killing off any unwanted pathogens, increasing the number of good bacteria and healing the gut wall can take months, and a good diet, particularly avoiding sugar, refined carbohydrates and alcohol, is important at this time. The liver may also need to be supported to help it cope with toxins created as the candida, parasites etc. die off.
Once the health of the gut has been restored, avoiding foods you are intolerant to for a few months can allow the body to adjust itself, and the food may then no longer be a problem.
IBS can be very embarrassing and debilitating, but don’t suffer in silence – natural medicine offers many possible solutions.