IBS - part two
Standard Treatment Options for IBS
Medical treatment of IBS is aimed at managing the symptoms because no identified cause can be pinpointed.
Treatment usually involves:
A muscle relaxant to relieve pain;
Complete avoidance of specific food groups/FODMAPS; and
laxatives or anti-diarrhoeals to normalise bowel movements.
“Neither of these address the underlying processes of IBS
or try to heal your gut.”
Laxatives and anti-diarrhoeals may make the discomfort and pain worse depending on the type you are prescribed. When subjected to rigorous study common muscle relaxants are shown to be no better than placebo.
It is becoming more common for people with constipation type IBS to be prescribed anti-depressants for IBS.
The theory is that they increase gut movement via serotonin activating the muscle motor complex responsible for moving things through the bowel. However, studies have shown that they won’t alleviate the IBS better than a sugar pill and have significant side effects.
Pain medication and antibiotics can be prescribed for severe cases where infection has been present or the risk of infection is high. While all of these medications may be necessary for a period of time none will address the underlying processes or cause of your IBS.
Nutritional Treatments for IBS
Key strategies for nutritionists centre around:
1. Holistic assessment & lab tests
A long consultation covers your medical, lifestyle and family history to understand what is influencing your condition. Blood or functional tests can identify what else is happening that contributes to or is a result of the gut changes you’ve been experiencing. Checking on inflammation, the immune system and nutrient and mineral deficiencies is an important step in getting a clearer picture.
Tests a nutritionist might look for:
— Full blood count and Iron studies - hyper-permeability can reduce absorption of key nutrients and minerals required for normal bodily processes.
— White blood cells - indication of immune responses.
— CRP & ESR — an indicator of inflammation & to rule out other inflammatory diseases.
— Stool test — details bacterial populations in the colon and the presence of pathogens.
If you doctor has already completed some of these tests we can use them as a starting point and move on to examining dietary changes that work for you.
2. Dietary Changes
You may be asked to keep a diary of your bowel movements in a 2 week period as well as a food and symptom diary. This is so we can limit food sensitivity but also design a diet that ensures you get all of the nutrients you need.
What triggers symptoms can be different for each individual. The right food encourages balanced gut bacteria and improves the function of intestinal cells. It can reduce inflammation and reactivity.
Gut cells turnover rapidly — every three days — presenting an opportunity to influence function and begin making changes that work.
Some dietary changes may include:
— Removal of common triggers such as gluten, wheat or dairy.
— Modified low FODMAP diet
— Addition of fibre up to 30g a day
— Reducing red meat consumption
— Altering vegetarian sources of fibre or fibre modification
3. Lifestyle changes
Stress reduction techniques including exercise, sleep and mindful eating are powerful in reducing anxiety and encouraging normal movement of muscles which surround our digestive tract.
Family schedule, work life, personal values and stress levels differ from person to person. Recommendations are customised to what works for you.
Some examples of lifestyle changes for IBS may include:
— Adopting proper sleep hygiene - altering stress response in the gut.
— Incorporating greater movement - Physical activity 30-40mins per day improves stress and anxiety in addition to stool consistency in IBS.
— Joining a group or community to encourage support networks - Quality of life and depressive symptoms are lifted by support.
4. Nutritional supplements
Supplements are prescribed only as required and specific to your case. The focus is vitamins and minerals that support the health and rapid turnover of your intestinal cells and restore any nutrient that you are deficient in and is affecting how well you function on a daily basis.
A nutritionist may use supplements such as:
— Glutamine - feeds intestinal bacteria which provide energy for your intestinal cells to repair and regenerate. Dramatically and safely reduces all major IBS symptoms.
— Digestive enzymes - improves breakdown of food molecules in the upper digestive tract and stimulates enzymes further down the intestines to continue breakdown of food molecules.
— Vitamin D - supports maturing immune cells.
— Zinc - Immune cell support and repair and growth of intestinal cells.
— Probiotics - can support rebalancing the bacteria in the intestines.
— Peppermint - reduces spasm in the bowel in some cases.
— Vitamin B - required for cellular turnover.
These are not exhaustive lists as all treatment is specific to your particular condition. The duration of treatment, dosage and your history dictate the type of treatment and what is effective for you.
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 30 mL per kg of body weight.
2. Increase fibre on a day to day basis beginning with something easy to digest like oats and vegetables. Start incorporating legumes and wholegrain a 1/4 cup at a time. Some mild bloating reactions are to be expected if you haven’t eaten these foods for a long period of time.
3. Increase movement in your day as naturally as possible.
4. If symptoms persist, please reach out to discuss your case.
Final Thoughts
Although it can seem daunting to make changes, know that our bodies are able to function well from a limited number of inputs — whole foods, water, exercise and oxygen. When our inputs include poor diets, a toxic environment and stress on an ongoing basis it interferes with these normal process. Any subsequent change is not always smooth sailing but bumps in the road are completely normal. Understanding both what is happening in your body and giving it time is key to restoring health.
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