Irritable Bowel Sydrome (IBS)

 

 

 

 

 

 

 

 

 

 

 

IBS is a label given to a group of people who have one or more of very common digestive symptoms. There are many other symptoms that are covered under the IBS umbrella, but four major symptoms usually stand out.

1. Diarrhea
2. Constipation
3. Abdominal Distension
4. Bloating

IBS can often get complex if it is associated with other conditions. The other conditions associated with IBS are;

1. Abdominal Migraine: This is a fancy term often given to kids who have periodic abdominal cramping and pain, vomiting, nausea. It’s rather a fancy way to say your stomach isn’t happy. This is a form of IBS in my experience and very treatable like IBS.
2. Anemia: when there is ongoing digestive and absorption problem, deficiencies are very common.
3. Celiac: when symptoms do not get better on a gluten free diet, IBS may be underlying and need to be investigated.
4. Colitis and Eosinophillic Esophagitis : are often intertwined with IBS and are very much treatable.
5. Crohns:  A inflammatory condition of the intestines that can overlap with IBS symptoms. It can be associated with bacterial overgrowth, food reactions or intolerances, candida overgrowth etc.

IBS symptoms may not be the same for everyone and can change periodically. Most of the symptoms also overlap with other diseases like Gall stones, Appendicitis or cancers. When screening tests are negative for these, patients are often left with a prescription of antidepressants or motility agents for life time.

How do I approach the cause of IBS?

Most IBS sufferers have multiple causes triggering the symptoms. Here’s a look at some of these providing an idea on the complexity of the illness.

1. SIBO: Small intestinal bacterial overgrowth, another complex condition, where there is excess growth of good bacteria in the small intestine.
2. Food allergies, food sensitivities, food reactions and primary intolerances: All of these have different mechanisms and cause various symptoms. It is necessary to decipher food intolerances from other food reactions and sensitivities that promote irritation and inflammation of the intestinal lining.
3. Post infectious IBS: As the name suggests, is a form of IBS that starts after an infection.
4. Motility disorders: Cause constipation or diarrhea arising due to various factors from stress and emotions to chemical imbalances.
5. Gut brain Axis dysregulation: Histamine, cortisol and serotonin are chemicals that play a key role in promoting intestinal permeability and initiate symptoms of IBS.
6. Exocrine pancreatic and Stomach acid insufficiency. These further perpetuates motility disorders and SIBO.

How is this approach to IBS different from conventional treatments?

Once a diagnosis of the cause is established through required testing and physical exam, I look for contributing factors that are obstacles to cure before initiating any treatments. More recently, I am also screening for sleep disorders and Histamine imbalances that contribute to the Gut and Hypothalamus pituitary adrenal axis imbalance.

Identifying these unique imbalances in different systems for each individual- Neurogical endocrine, immune and gastrointestinal helps provide a comprehensive and targeted treatment plan for long term management of IBS.

Treatments vary depending on the cause and triggers in each individual. After stimulating the vital force of the body and removing obstacles to cure, I often use a stepped approach for long term positive outcomes in IBS through Herbs, homeopathy and targeted supplements and Psycho/behavioral interventions that work towards,

1. Stabilizing adrenal and immune function if there is HPA dysregulation.
2. Modifying dysbiotic lifestyle factors (factors in one’s lifestyle that promote microbial imbalances).
3. Implementing a sustainable microbiome diet.
4. Stabilizing the microbial flora.
5. Improve motility of the intestines.
6. Replenish nutrients that promote digestive and immune factors.
7. Restore gut barrier/ intestinal permeability.

Irritable bowel does not have to be a life sentence. As you can see it’s a complex puzzle with a variety of potential interrelated causes. The point is, there is definitely a cause. If you have a digestive problem and no one has been able to help you with, don’t give up. We have treated considerable number of patients at the clinic successfully with this comprehensive approach.

 

Resources:

1.Ghoshal UC, Srivastava D. Irritable bowel syndrome and small intestinal bacterial overgrowth: meaningful association or unnecessary hype. World J Gastroenterol. 2014;20(10):2482-2491

Thompson JR. Is irritable bowel syndrome an infectious disease. World J Gastroenterol. 2016;22(4):1331-1334

Lee YJ, Park KS. Irritable bowel syndrome: emerging paradigm in pathophysiology. World J Gastroenterol. 2014;20(10):2456-2469.

Zhang L, Song J, Hou X. Mast Cells and Irritable Bowel Syndrome: From the Bench to the Bedside. J Neurogastroenterol Motil. 2016;22(2):181-192

Wilkins T, Pepitone C, Alex B, Schade RR. Diagnosis and management of IBS in adults. Am Fam Physician. 2012;86(5):419-426

Morito Y, Aimi M, Ishimura N, et al. Association between sleep disturbances and abdominal symptoms. Intern Med. 2014;53(19):2179-2183.

Akahashi T. Interdigestive migrating motor complex -its mechanism and clinical importance. J Smooth Muscle Res. 2013;4999-111.

Hayes PA, Fraher MH, Quigley EM. Irritable bowel syndrome: the role of food in pathogenesis and management. Gastroenterol Hepatol (N Y). 2014;10(3):164-174