IBS is a common and very frustrating disease which affects countless women. The average age of onset is between 20 and 29 and women are thought to be affected twice as often as men. The majority of people with IBS – about 95 per cent – will now seek medical help for their symptoms.
What causes IBS?
Having worked with lots of women with IBS, the three main causes in my experience are:
Candida or parasites
Your integrated medical prescription:
First you need to establish what the underlying causes are, because this is key to a lasting resolution of the symptoms.
IBS is associated with a number of symptoms that vary both in their frequency and severity. The following criteria are used by most doctors to assess the possibility of IBS. If you have experienced abdominal discomfort or pain for at least 12 (not necessarily consecutive) weeks in the last year and if your discomfort or pain is accompanied by two or more of the following features, then you may have IBS.
Your pain or discomfort is relieved after you have a bowel movement.
When your pain or discomfort starts, you have a change in your usual number of bowel movements (either more or few).
Abnormal bowel frequency (more than three per day or less than three per week).
Abnormal stool passage, including straining, urgency or the feeling that you may not have completely emptied your rectum.
Abnormal stool (lumpy/hard or loose/watery).
Passage of mucous in the stool.
Abdominal bloating, distension or swelling.
Consider the medical options
Because IBS is so readily treated using an integrated medical approach that deals with the underlying causes, I rarely recommend medication. However, there are circumstances when it has its uses.
Your doctor may prescribe anti-spasmodic medication to help relax the walls of the bowel.
If you have diarrhoea your doctor will probably recommend loperamide, a drug which works by stopping your bowels going into spasm.
If you have constipation, your doctor will probably offer you a fibre-containing laxative such as ispaghula husk (brand names include Fybogel, Isogel and Ispagel). These help to reduce IBS symptoms in about two thirds of people who take them. They are useful in the short-term but in the long-term it is more important to get your fibre from a healthy diet.
If all of the above fail, you doctor might prescribe a tricyclic antidepressant medication such as amitriptyline, clomipramine, doxepin or trimipramine but I would steer well clear of antidepressants as you will not need them if you deal with the underlying causes of IBS.
Food intolerances: This is a phrase used to describe a range of detrimental responses to a specific food or ingredient. The most common are intolerances to cow’s milk and cheese, wheat, gluten (found in wheat, rye, barley and oats), corn, beef, yeast, eggs, garlic, nuts, seeds, kiwi and soya.
Stress: Stress is the ‘bodymind’s’ natural response to an event or experience which at some level we believe we don’t have the resources to deal with adequately. When we suppress our stress response or fail to deactivate and discharge the energy that arises in response to the stress, this can, and often will, compromise our health and vitality.
Parasites or candida: Often called dysbiosis, this refers to a condition in which the normal healthy population of beneficial bacteria in the intestines has been disrupted, leaving it open to the overgrowth of yeast (candida), fungi, parasites and potentially harmful strains of bacteria. This can be caused by a history of using antibiotics, the Pill or steroids; low fibre intake; high sugar and processed food intake, excessive alcohol consumption and stress.
Poor diet: Every aspect of you – your mood, weight, energy levels, libido, thoughts, sleep, vitality and even IQ is influenced by the foods you eat. A healthy eating programme that meets the nutritional and energy requirements of your body will help support the healing process, reduce inflammation and prevent disease.
Lactose intolerance: Avoiding lactose (present in milk and some other dairy products) may help to reduce IBS symptoms in people with IBS who are lactose intolerant.
Aloe vera juice: This is my first choice of supplement for the majority of nonemotionally- induced IBS patients. There is a lot of anecdotal evidence to suggest that it can help reduce symptoms such as diarrhoea and constipation, gut pain, bloating and wind.
Acidophilus probiotic: This has been found in some studies to significantly improve symptoms and quality of life in patients with IBS. Probiotic therapy, primarily in the form of lactobacillus acidophilus, is most useful for people with dysbiosis. It’s important to purchase a well known brand and take it for at least six months.
Psyllium husk: This is a high fibre, bulkforming laxative that might help to improve your bowels and reduce the symptoms of IBS.
Peppermint oil: With or without caraway seed, this can act as a natural anti-spasmodic. If taken as capsules, they should be entericcoated so they can dissolve in the intestines rather than the stomach. As an alternative, try drinking peppermint tea after your meal.
Consider other complementary approaches
While there is no definitive evidence that these can help your IBS, some patients find the following useful in supporting their programme:
Another important step in making the diagnosis of IBS is to exclude the possibility of you having another health problem masquerading as IBS. To help you and your doctor decide whether this is a possibility, read through the following list of red flags. If you have any of the following, you will need to undergo further investigation:
Did your symptoms start after the age of 45?
Did your symptoms start shortly after taking antibiotics?
Are you anaemic or do you have blood in your stools?
Do you experience nausea, vomiting or fever?
Are you anorexic?
Is there a family history of colonic carcinoma, inflammatory bowel or coeliac disease?