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Irritable Bowel Syndrome IBS

Dr. Karol M.D Article by: Dr. Karol M.D
Irritable Bowel Syndrome IBS

Irritable Bowel Syndrome


Welcome back all of my dear readers. This months blog themes are Cancer awareness (prevention and what to do once you got it), and Irritable Bowel Syndrome (IBS). I will begin with the latter.


The prevalence of IBS in the Canadian population is 6%. It is 3 times more likely to be diagnosed in women than in men and is responsible for 30 billion dollars annually in medical costs and non medical costs (e.g. work absenteeism) in the US.


The symptoms are mostly abdominal pain with a predominance of diarrhea, constipation or both alternating with one another. Other symptoms are excessive flatulence and bloating.


A clear cause is still unknown. There are two prevalent theories. One is that a large proportion of IBS occurs after some kind of gastrointestinal infection. The other large proportion of IBS occurs in individuals that have undergone some kind of significant stressful event. This stressful event may have happened just prior to the IBS symptoms or years before. Needless to say psychological trauma and/or GI infections seem to correlate strongly with this condition.


In regards to GI infection the theory goes that infectious toxic bacteria start predominating in the GI tract displacing the good probiotic bacteria. This leads to damage to the GI inner lining, absorption of toxic compounds as well as the loss of all the benefiting effect of probiotics (please see my blogs on probiotics to get more detail on this topic).


In relation to the psychological stress/trauma theory, there are nerve connection between the brain and the GI tract. Most of these connections are part of the parasympathetic nervous system and thus part of the nervous system that we are not aware off and do not control voluntarily. Most of these connections perform the function of GI peristalsis (i.e. contractions of the GI tract to move food contents and feces forward) as well as secretion of gastric juices including acid as well as some enzymes and hormones that regulate GI function and the digestion of food. The theory goes that psychological trauma can influence these nerve connections between the brain and the GI tract in such a way as to produce the symptoms of IBS.


There is no specific test for this condition. It is what is called a diagnosis of exclusion. We eliminate all other possibilities that have an organic cause (i.e. a defect in tissue or organ structure or some kind of physiological cause) by doing tests (for example checking the presence of blood in stool to exclude cancer or a bleeding ulcer) and when everything else that is possible is excluded we are left with IBS. I know, sounds primitive, but a lot of medicine is still at its elementary stages.


Considering the two most probable causes that are connected with IBS (i.e. stress and GI infections) it makes sense to concentrate on natural remedies that prevent or mitigate these potential culprits. Indeed prevention of GI infections with probiotics or administering probiotics after a GI infection decreases the prevalence of IBS and/or mitigates its symptoms in most cases. Furthermore in many individuals probiotics completely eradicate the symptoms of IBS. Stress management in the form of meditation, yoga, tai chi and regular exercise also help in a large proportion of individuals. I will be writing more about these modalities for stress relief in my future blogs this month. In regard to stress, if the cause is some kind of psychological trauma that has occurred in the past and its psychological consequences may be hidden in the unconscious part of the mind. Cognitive therapy may be very effective to revealing these conflicting emotions in order to bring them to the surface of our consciousness. In many cases this kind of therapy eradicates the unconscious psychological conflict and thus erases the aberrant connection between brain and the GI tract. This kind of therapy may also be in the form of psychotherapy and hypnosis. This is exactly why a trustworthy and emotionally open relationship between the patient and the clinician is so important, especially for patients with IBS.


Of course both of these treatment modalities take time to cause a positive effect. Whereas IBS symptoms may come and go at a heartbeats notice. Therefore it makes sense to not only concentrate at treatment modalities that target the cause of the condition but also to concentrate on the most annoying symptoms and try to eradicate them as soon as possible. Thus for constipation predominant IBS, soluble fiber (for example psyllium) seems to provide significant relief in a large proportion of individuals. Natural laxatives (which I will discuss in future blogs this month) are another option. For diarrhea predominant IBS natural anti-spasmotics provide relief.


Another important aspect for treating IBS is to adhere to a diet that is as low in refined carbohydrates as possible. This has the added benefit of helping prevent the development of diabetes and obesity. The diet in IBS should be rich in lean proteins, very low on carbs especially simple carbs with a high glycemic index (for example sugar, honey, sweets, white bread, white past, white rice, pop drinks and fruit juices) and rich in antioxidants from vegetables and fruits. Raw or slightly steamed vegetables add the additional benefit of providing high doses of fiber.


Finally there are a number of medications (which are the main therapeutic modality of hospital and majority of medical clinic protocols) that are prescribed by doctors for IBS. Many of them are effective at masking the symptoms of IBS and bringing temporary relief from symptoms. However they only mask the condition and do not treat it. Furthermore majority of them are highly toxic with a number of side effects, some of them very serious. I will be discussing these as well as their pros and cons in my future blogs on this topic during the month of April. I invite you to follow my blogs this month, especially if you do have IBS or know of someone who has IBS as what you are about to read may be very helpful in bringing relief from this condition and may even contribute to total healing.