Natural treatments for Irritable Bowel Syndrome

Digestion | July 27, 2016 | Author: Naturopath

Natural treatments for Irritable Bowel Syndrome

Irritable Bowel Syndrome (IBS) is a condition that causes abdominal pain and cramping, diarrhoea and/or constipation, nausea, flatulence and bloating. If you suffer from IBS, you understand how frustrating it can be trying to find reliable symptom relief. As IBS affects a broad range of people, the most effective treatments are tailored to each individual and their particular circumstances by qualified practitioners. Herbal medicine, nutritional supplements and alternative therapies can all do wonders for different people at different times.

So how can you get IBS relief?

There are five key habits that will help everyone with IBS. These lifestyle changes will also build a foundation of good gut function so that herbal and nutritional treatments can be effective.

The type of IBS you suffer from will determine which of these habits to focus on first.

The classifications of IBS are:

IBS-D for symptoms that are predominated by diarrhoea
IBS-C for symptoms mostly involving constipation
IBS-A for an irregular bowel pattern that alternates (that's where the A in IBS-A comes from) from constipation to diarrhoea. IBS-A is sometimes called mixed state IBS.

If you're unsure of which category you fall into, try keeping a symptom journal for a month. Track your bowel motions and any other IBS-related symptoms to see if there is a pattern.

CAUTION: The essential and often-ignored step in dealing with IBS is to ensure that you have a definitive diagnosis from elimination of other possible diagnoses. This means that all other possible causes of your gastrointestinal distress must be ruled out by a doctor.  Many of the symptoms of IBS are early signs of more serious conditions such as Inflammatory Bowel Disease or celiac disease, and these need to be investigated properly. If you ever experience blood or mucus in your stool, or experience pain that isn't relieved by paracetamol or other over-the-counter pain killers, tell your doctor immediately.

Five Key Habits for IBS Relief:

1. Increase Dietary Fibre

shutterstock_28140595Best for: IBS-C While everyone knows that fibre helps to relieve constipation, few people know how to increase fibre in their diet, or why it works.
How: Gradually eat more foods that are high in soluble fibre. You must introduce high fibre foods slowly, or you may suffer from diarrhoea or worsening constipation.
Be sure to increase your water intake as you increase your dietary fibre intake to keep things moving smoothly.

Why: This type of fibre will soften the stool and make it easier to pass. Key sources of soluble fibre include oats, lentils, flaxseeds, apples, berries, cucumbers, carrots, celery, oranges and pears.

2. Drink Enough Water

shutterstock_239216878Hydration is another fool-proof way to improve your digestion that people often dismiss as being too simple. But drinking the right amount of water can easily prevent and relieve constipation and diarrhoea by giving the stool the right amount of bulk and fluidity. 

In people who suffer from IBS-D, there is a risk of dehydration from water loss via diarrhoea. Even mild dehydration can contribute to exacerbated IBS symptoms, as well as other issues such as headaches, mood swings, depression and irritability.

So how much water is enough? It's easy: 1 litre of water for every 25kg of body weight, per day. [Your body weight in kg] / 25 = how much litres you need per day!

3. Exercise

shutterstock_232027741Thirty minutes of moderate-intensity aerobic exercise has been shown to be an effective treatment for IBS, by improving bowel movement and reducing anxiety levels. Abdominal exercises like crunches aren't just good for building a six-pack – they can strengthen and tone the colon muscles, thereby encouraging regular bowel motions.

Consider Pilates, yoga, a dance class or taking up a martial art.

4. Support Yourself Through Stress

Physical and emotional stress is hard to avoid, particularly when you are suffering from symptoms of IBS! Having tools that will support your body through the inevitable ups and downs of life can reduce the frequency and severity of IBS flare-ups. This can be easier said than done, as IBS is often seen in people who suffer from psychological conditions such as Post Traumatic Stress Disorder.
To begin, try relaxation techniques, meditation, yoga, massage, journalling, acupuncture or deep breathing exercises. If stress or anxiety continue to impact your health, consider seeking support from a therapist or psychologist.

5. Identify & Eliminate Common Triggers

For people who only suffer from occasional flare-ups, a beneficial method for identifying triggers is to keep a “reverse food diary”: when you experience symptoms, write down everything you ate for the 3 days prior to the onset of symptoms. After you have recorded a few flare-ups, you may be able to analyse your diaries and identify key foods that triggered the symptoms. If your IBS symptoms are more constant, you may need to keep a detailed food and symptom diary for a week or more. This can either be with pen-and-paper, or you can use a phone app to track what you eat and the symptoms you experience. Be sure to note any changes in severity or character of your symptoms. Even with all that information, it can be hard to pinpoint what is triggering you. If you are overwhelmed with possibilities of what could be aggravating your IBS, seek objective advice from a qualified nutritionist or naturopath.

The most common triggers of IBS are:

  • Caffeine. Found in coffee, tea, green tea, macha, cocoa, chocolate, cacao and some medications.
  • Soft drinks. Including diet and energy drinks, and some sports drinks.
  • Refined sugar. Found almost everywhere! Tolerance to refined sugar is different for every individual.
  • Alcohol. Keep an eye out for alcohol in places you wouldn't expect it, including kombucha and herbal tinctures!  
  • Gluten. While celiac disease or gluten allergy is often misdiagnosed as IBS (get tested!), gluten intolerance is a common trigger for IBS. Be sure to get tested for celiac disease before cutting gluten out of your diet, though – the test only works if you have been eating gluten regularly.
  •  Dairy. ​​Yogurt and butter are often better tolerated than milk and cheese in people with IBS
  • FODMAPs. FODMAP intolerance has recently been found to be quite common in people with IBS . When this happens, the gastrointestinal tract can't digest or absorb particular types of molecules found in foods (Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols). FODMAPs are found in many foods and it isn't easy to self-diagnose a intolerance, nor is it a good idea to cut out all foods containing FODMAPs without professional guidance. See a practitioner if you suspect you may have any kind of intolerance contributing to your gastrointestinal symptoms.Natural Therapies for IBS Symptom Relief.
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With the five key habits in place, your gastrointestinal tract will be beginning to repair, and you may have experienced some relief from IBS symptoms. Now herbal and nutritional therapies can provide additional relief.

Psyllium Husks

Best for: IBS-D or IBS-Ashutterstock_361173833 Psyllium husks are highly absorbent “shells” from a South Asian seed. They are available for sale as a functional food at many health pharmacies, food stores and supermarkets.

When combined with water, psyllium husk become mucilaginous – they get gooey! As a functional food, they become a source of soluble fibre that adds bulk to the stool, thereby reducing symptoms of diarrhoea in IBS-D and IBS-A patients.

As an added benefit, the process of colonic fermentation of soluble fibre produces a byproduct called butyrate. This is an important short-chain fatty acid that has also been shown to reduce IBS symptoms of bloating and pain. Take 1-2tsp of psyllium husks in a large glass of water, 1 – 2 times per day and you should see improvement.

Slippery Elm

The slippery elm tree (Ulmus rubra) is native to North America. Medicinally, its powdered bark is used as a demulcent for mucous membranes – in IBS, it has a soothing effect on the walls of the gastrointestinal tract. It's also astringent, causing epithelial barriers to tighten up, promoting repair of leaky gut, and preventing infections. Like psyllium husks, slippery elm is mucilaginous and adds bulk to the stool, helping to relieve diarrhoea. A 2010 pilot study showed that, in combination with other herbs, slippery elm helped to relieve IBS-C patients but not those suffering from IBS-D. However, the other herbs in the formulas may be responsible for these results as slippery elm has been used traditionally for all types of IBS. Take 1 – 2 teaspoons of powder in water, 1- 2 times per day. Be sure to drink plenty of water to prevent constipation, and take at least 1 hour away from any medication or other supplements.

Probiotics

Tshutterstock_380527078he microbiome of the gut is a hot topic in science circles. Imbalances of different strains of gut bacteria is often implicated in gastrointestinal symptoms, and many other conditions.

The microbiome balance is about the number of “good guys” (the types of bacteria who keep our intestines healthy and happy) versus “bad guys” (or pathogenic bacteria, the types who cause inflammation and promote symptoms). Taking probiotics can boost the numbers of the “good guys” to outnumber the “bad guys” in order to re-balance the microbiome. Particular strains of probiotic bacteria are used to treat different conditions. 

For most people, a broad-spectrum probiotic can be beneficial in relieving many of the symptoms of IBS. However, a 2016 meta-analysis showed that the greatest improvement in symptoms occurred in studies that used single strains of bacteria to treat IBS. In particular, Saccharomyces cerevisiae holds promise in relieving symptoms of IBS-C , and Sacchromyces boulardii may be beneficial in IBS-D.
It takes 1 – 3 months of probiotic therapy to re-balance the microbiome of the gut, and this time frame can be prolonged by stress, caffeine, alcohol, refined sugar, and saturated and trans fats, which all kill off the good guys no matter how many millions of them you're getting from your probiotic.

Peppermint Oil

Best for: IBS-D or IBS-A Peppermint oil has been used for centuries in the relief of gastrointestinal upsets due to its antispasmodic actions. Traditionally the oil would be applied topically on the skin of the abdomen, or brewed in peppermint tea (both are still excellent, gentle remedies!). Now, enteric-coated capsules can deliver the peppermint oil directly to the intestines where it can deliver a more targeted antispasmodic effect to reduce cramping and diarrhoea .shutterstock_144199450

Chamomile Tea

German chamomile flower is a popular herb with a strong history of use in gastrointestinal treatment, all the way back to Ancient Egypt and Rome. It has antispasmodic properties, helping to relieve cramping and bloating. It is also a gentle sedative; a chamomile tea in the evening is an ideal way to soothe the tummy and get a good night's sleep.

The Upshot:

The symptoms of irritable bowel syndrome are notoriously difficult to treat, but you can find relief by following the five key lifestyle changes, combined with proven herbal and nutritional treatments.

References:

MerckManual(2013)IBS.http://www.merckmanuals.com/professional/gastrointestinal_disorders/irritable_bowel_syndrome_ibs/irritable_bowel_syndrome_ibs.

html?qt=IBS&alt=sh Johannesson, E., Simren, M., Strid, H., Bajor,A. & Sadik, R. (2011) Physical activity improves symptoms in irritable bowel syndrome: a randomized controlled trial. American Journal of Gastroenterology, 106:5, 915 – 922.

http://www.ncbi.nlm.nih.gov/pubmed/21206488 Wang, H. J., Zakhari, S. & Jung, M. K. (2010) Alcohol, inflammation, and gut-liver-brain interactions in tissue damage and disease development. World Journal of Gastroenterology, 16:11, 1304 – 1313.

http://www.ncbi.nlm.nih.gov/pmc/articles/pmid/20238396/ McKenzie et al. (2016) British Dietetic Association systematic review and evidence-based practice guidelines for the dietary management of irritable bowel syndrome in adults (2016 update). Journal of Human Nutrition and Dietetics.

http://www.ncbi.nlm.nih.gov/pubmed/27272325 Gibson, R. P. & Shepherd, S. J. (2010) Evidence-based dietary management of functional gastrointestinal symptoms: The FODMAP approach. Journal of Gastroenterology and Hepatology, 25, 252 – 258.

http://www.ncbi.nlm.nih.gov/pubmed/20136989 Hawrelak, J. A. & Myers, S. P. (2010) Effects of two natural medicine formulations on irritable bowel syndrome symptoms: a pilot study. Journal of Alternative Complementary Medicine, 16:10, 1065 – 1071.

http://www.ncbi.nlm.nih.gov/pubmed/20954962 Sisson, G., Ayis, S., Sherwood, R. A. & Bjarnason, I. R. (2014) Randomised clinical trial: a liquid multi-strain probiotic vs. placebo in the irritable bowel syndrome – a 12 week double-blind study. Alimentary Pharmacology & Therapeutics, 40, 51–62. Zhang, Y. et al. (2016)

Effects of probiotic type, dose and treatment duration on irritable bowel syndrome diagnosed by Rome III criteria: a meta-analysis. BMC Gastroenterology, 16:1.

http://www.ncbi.nlm.nih.gov/pmc/articles/pmid/27296254/ Spiller, R. et al. (2016) Randomized double blind placebo-controlled trial of Saccharomyces cerevisiae CNCM I-3856 in irritable bowel syndrome: improvement in abdominal pain and bloating in those with predominant constipation. United European Gastroenterology Journal, 4:3, 353 – 362.

http://www.ncbi.nlm.nih.gov/pubmed/27403301 Abbas, Z. et al. (2014) Cytokine and clinical response to Saccharomyces boulardii therapy in diarrhea-dominant irritable bowel syndrome: a randomized trial. European Journal of Gastroenterology and Hepatology, 26:6, 630 – 639.

http://www.ncbi.nlm.nih.gov/pubmed/24722560 Alam, M. S. et al. (2014) Efficacy of Peppermint oil in diarrhea predominant IBS - a double blind randomized placebo - controlled study. Mymensingh Medical Journal, 22:1, 27 – 30. http://www.ncbi.nlm.nih.gov/pubmed/23416804 Ford, A. C., Talley N. J., et al. (2008)

Effect of fibre, antispasmodics & peppermint oil in the treatment of irritable bowel syndrome,. BMJ, 337. http://www.bmj.com/content/337/bmj.a2313

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