IBS - part one
Want to know more about nutritional treatment for IBS?
Check out IBS - Part 2
You suspect you have IBS
— what does it mean for you?
Bloating, pain, constipation, and diarrhea — symptoms you’re more than likely to have been suffering from for some time now.
Irritable bowel syndrome (IBS) can be debilitating, sucking the joy and energy out of your day. Even if you’ve only had a short time you can feel tired all the time and very sensitive to any reactions in your gut.
You’re not alone. It is reported that 10% of Australians-- that’s 2,460,000 of us suffer from symptoms of IBS! [1] That’s staggering, so lets look deeper at it and what treatment options could be available to you.
What is IBS?
Irritable bowel syndrome is a functional gastrointestinal disorder.
What does that mean?
Basically, it reduces your quality of life. NO one specific test can identify it and NO clearly defined medical reason has been identified as it’s cause. It can’t just be treated with something from the pharmacy.
- The bacteria in our gut and our intestinal cells are responsible for the healthy processing and absorption of food molecules.
- Well functioning intestinal cells let in nutrients that we need and keep out harmful bacteria and molecules that our body won’t recognise. This is a complex communication between our bacteria, our cells and the mucous lining in our intestine.
This communication can be disrupted when-
We stop feeding our gut bacteria the food they need to survive OR
We experience severe stress OR
We take antibiotics, steroid or some pain medication OR
We experience a case of gastro.
When the barrier is no longer being selective and larger molecules get through we call that intestinal hyperpermeability.
- Intestinal hyperpermeability leads to an overactive immune system. Excessive immune cell response leads to inflammation. Inflammation maintains the hyperpermeability and the bloating, pain and cramping symptoms you experience in IBS. It can become a vicious cycle when constipation or diarrhoea develop as well.
- IBS isn’t always about what is happening lower down in your gut. If digestion doesn’t begin properly in the mouth and stomach, or the right enzymes to break down your food are not released then larger molecules make it to your intestines. Normally these molecules would not get through your intestinal barrier. But, in an inflamed gut they pass by this barrier triggering our immune system.
As you can see it is a complex condition which requires time to understand your personal symptoms and lifestyle.
Your Symptoms
To be honest your symptoms may not fit the neat categories which lead to a diagnosis of IBS. Officially a diagnosis is given based on The ROME IV criteria — a set of rules that help classify your IBS and make sure it’s not something else. The rules are:
- you must be experiencing recurring abdominal pain at least one day per week
- pain related to defecation — though it may be relieved by passing a stool — and changes to your bowel habits for at least 6 months prior to diagnosis.
Yet, I find that client symptoms can vary significantly, ranging from headaches and hives to constipation and severe period pain. The most common are:
- pain: cramping, griping, stomach and skin sensitivity
- changes in the shape and form of your stools (poo);
- changes in how often you got to the toilet and how urgent the need is
- constipation, diarrhoea, or both;
- abdominal bloating & passing wind.
Symptoms generally change over time and can become worse. For instance, you can feel intense lethargy from the pain or improperly absorbing the nutrients your body needs. When these symptoms cluster up it can be too much. Even with a diagnosis you still don’t know what it is you can do to make it all go away. It is hard to get answers without being made to feel like it is all in your head.
Do you have to wait 6 months (based on the criteria) before you seek help?
No
Should you start by considering some dietary changes before this point is reached?
Absolutely
What can you do right now?
These suggestions are straight forward ways to start understanding what food makes you feel your best and worst. Most importantly there is the potential to make a big difference with little effort by adopting these changes at the outset.
1. Increase daily water intake — a general guide is 35 mL per kg of body weight.
2. Increase natural fibre, regardless of IBS type. This isn’t fibre in processed foods, but simply vegetables, salad, legumes and whole grains. Start with only small quantities each day. Focus on oats and vegetables first.
3. Increase movement in your day as naturally as possible.
4. If symptoms persist, please reach out to discuss your case or make a booking online.
REFERENCES
Chang, L. (2017). Updates to the Rome criteria for irritable bowel syndrome. Gastroenterology & hepatology, 13(5), 304.
Soares, R. L. (2014). Irritable bowel syndrome: a clinical review. World journal of gastroenterology: WJG, 20(34), 12144.
Johannesson, E., Ringström, G., Abrahamsson, H., & Sadik, R. (2015). Intervention to increase physical activity in irritable bowel syndrome shows long-term positive effects. World journal of gastroenterology: WJG, 21(2), 600.
Daley, A. J., Grimmett, C., Roberts, L., Wilson, S., Fatek, M., Roalfe, A., & Singh, S. (2008). The effects of exercise upon symptoms and quality of life in patients diagnosed with irritable bowel syndrome: a randomised controlled trial. International journal of sports medicine, 29(9), 778.
Zhou, Q., Verne, M. L., Fields, J. Z., Lefante, J. J., Basra, S., Salameh, H., & Verne, G. N. (2018). Randomised placebo-controlled trial of dietary glutamine supplements for postinfectious irritable bowel syndrome. Gut, gutjnl-2017.
Wald, A., Rakel, D. (2008). Behavioural and complementary approaches for the treatment of irritable bowel syndrome. Nutrition in Clinical Practice. 23(3), pp284-292.
McCullough, R., McCullough, J. (2017) Deciphering the pathophysiology of irritable bowel syndrome and functional gastrointestinal disorders—an alternative model for pathogenesis: cytokine controlled transepithelial multi-feedback loop. Translational Gastroenterology & Hepatology, 2-18.
Ng, Q., Soh, A., Loke, W., Venkatanarayanan, N., Lim, D., & Yeo, W. S. (2018). A meta-analysis of the clinical use of curcumin for irritable bowel syndrome (IBS). Journal of clinical medicine, 7(10), 298.
Parisi, G. C., Zilli, M., Miani, M. P., Carrara, M., Bottona, E., Verdianelli, G., ... & Tonon, A. (2002). High-fiber diet supplementation in patients with irritable bowel syndrome (IBS): a multicenter, randomized, open trial comparison between wheat bran diet and partially hydrolyzed guar gum (PHGG). Digestive diseases and sciences, 47(8), 1697-1704.