Irritable Bowel Syndrome

Though the symptoms of irritable bowel syndrome are very real, tests often show no abnormalities. But doctors who once said 'It's all in your head' now have a better understanding of this frustrating disease, which affects 15-20% of adults.

What is it?

Normally, food is propelled through the digestive tract by rhythmic contractions of the intestinal muscles, a process called peristalsis. In irritable bowel syndrome (IBS), these muscles go into spasm, and the contractions become uncoordinated. This disturbance can cause the intestine's contents to move too fast or too slow, leading to abdominal pain and either diarrhoea or constipation. An older term for IBS is 'spastic colon'.

What causes it?

Over the years, researchers have proposed many causes for IBS, none of which has ever been proved. The list of suspects include a bacterial, viral or parasitic infection; overuse of antibiotics; lctose intolerance; or adverse reactions to foods (such as wheat or yeast). Some experts think people with IBS have highly sensitive smooth muscle tissue, not only in the gastrointestinal tract but also elsewhere in the body. Others believe that IBS is the result of an inflammation in the lining of the intestine. One underlying factor in almost all cases of IBS, however, is that stress aggravates the symptoms. Because no one is sure exactly what makes bowel function go awry, doctors tend to diagnose IBS by eliminating other disorders with similar symptoms, such as diverticulitis or inflammatory bowel disease.

What are the symptoms?

• Diarrhoea, constipation, or alternating bouts of each (usually after meals) for several months.
• Abdominal cramping that is often relieved by bowel movement.
• Mucus in the stools.
• Flatulence and bloating.

Are there any natural therapies?

Natural supplements offer a good way to control many IBS smptoms. Enteric-coated peppermint oil capsules – which ensure that the oil is released in the intestine, not the stomach – are very effective in calming the intestinal spasms that cause abdominal pain, as well as soothing other IBS symptoms. In a study of 110 people with IBS, enteric-coated peppermint oil reduced abdominal pain in 79% of those taking it and eliminating the pain in 56%. Virtually no adverse reactions were seen.

Psyllium, a type of dietary fibre, eases IBS symptoms for many people – although not for all. In most cases, it works to correct constipation and is useful for diarrhoea because it absorbs water in the intestine an adds bulk to the stool. (Bulk also seems to lessen the severity of spasms.) Drink at least eight glasses of water a day when using psyllium. If you find that it aggravates your symptoms, stop taking it.

Acidophilus, a type of 'good' bacteria that normally inhabits the intestine, helps digest food and prevent the harmful bacteria that cause disease from growing unchecked. FOS (fructo-oligosaccarides), sometimes added to acidophilus supplements or available separately, comprises indigesitible carbohydrates that feed the friendly bacteria.

What else can I do?

• Add more high-fibre food, such as fruits, vegetables, grains and legumes, to your diet. But do it slowly to minimise bloating and wind. Eating lots of these foods may eliminate the need for psyllium.
• Eat smaller, more frequent meals. Limit caffeine, alcohol and foods high in fat. Eliminate certain goods and add them back one at a time over several weeks to find out which, if any, cause symptoms.
• Take control of stress. Relaxation techniques or biofeedback may help.
• Exercise for at least 20 minutes a day to keep the bowels moving normally and reduce stress.

Did you know?

Lactose intolerance (a sensitivity to the sugars in milk products) may trigger IBS symptoms. The ability to digest lactose tends to decline with age because of a decreased amount of the enzyme lactase in the small intestine.