Naturopathic guide to IBS

Do you suffer from Irritable Bowel Syndrome (IBS) or have some of the signs and symptoms? You may be sick and tired of having constipation day in day out, or bouts of diarrhoea or a combination. You may be feeling bloated, or have nausea and pain. Overall this condition is really affecting your zest for life.  

Up to 50% of visits to the GP for gastrointestinal complaints are for IBS. IBS is the most common functional disorder of the digestive system and there is no definitive cause. Instead it is multi-faceted which is where naturopathy fits into the picture to help pin-point, alleviate and better manage your symptoms.

The symptoms vary from person to person and whilst the cause is unknown, research is shedding light giving a little more understanding of the condition. IBS is debilitating to the individual and affects up to 20% of the world-wide population, predominantly women.

The signs and symptoms are multiple and include any combination of:

1. Constipation

2. Diarrhoea

3. Alternating constipation and diarrhoea

4. Bloating

5. Indigestion

6. Nausea

7. Abdominal pain or lower back pain

Exacerbating factors are numerous, and vary from person to person and can be very complex. Amongst the research undertaken, major areas of concern that cause a negative impact for the condition include:

1. poor gastrointestinal (gut) flora

2. inflammation of the gut wall mucous membrane

3. maladaptive or poorly handled stress causing effects via the gut-brain-axis

4. genetic influences

5. history of digestive tract infection – e.g. parasite

6. history of digestive tract surgery – e.g. removal of gall bladder

Poor gut flora

Many factors influence the health of your gut flora or microbiome including dietary intake, the way you handle stress, and history of antibiotic usage. Of these, the main area that we have control over from the get go is dietary intake. Bowel flora health promoting foods are called prebiotics. Prebiotics include the fibres in our food, which provide fuel for our little ‘good gut bugs’ or microbes in our large intestine. Prebiotic foods include artichokes, olives, sauerkraut, kimchi and other fermented vegetables, garlic and onions, asparagus, bananas, legumes, barley, wild greens, tomatoes and the fibre in our fruits and vegetables. The Mediterranean style diet is prolific in both prebiotic and probiotic foods and hence is health promoting.

Inflammation to the gut wall mucous membrane

Inflammation of the digestive tract is caused by various factors including a history of parasite infection, undiagnosed food intolerance or allergy and the impact of stress. Sometimes it can be a ‘chicken and egg’ scenario because the food intolerance may not have been there before the inflammation set in and vica-verca. Research has shown that stress plays a part on intestinal permeability commonly known as ‘leaky gut’ via communication through the gut-brain axis via the vagal nerve. What happens is the mucous membrane becomes porous, and food particles escape through the membrane leading to inflammation, gut damage and poor nutrient absorption. Food intolerance and/ or allergy should be identified, which can be a little tricky in the case of an intolerance, especially with delayed immunoglobulin reactions (IgG and IgA).

Poorly managed stress

A person who is highly stress or suffering from anxiety or depression may have poor bowel function such as diarrhoea or constipation and bloating – typical symptoms of IBS. This is because our nervous system for digestion (parasympathetic) is the complete opposite to the nervous system that responds to stress or anxiety (sympathetic). A meta-analysis of functional magnetic resonance imaging (MRI) reported differences in patients with IBS in terms of brain responses relative to abdominal bloating. The communication channels via the brain-gut axis where messages in the brain influence the automatic response on digestion cannot be underestimated. Further, research has found that a poorly diverse microbiome (gut flora) may instigate poor stress handling which again creates a chicken-egg scenario as to which impact comes first.

Genetic influences

Within the specific area of the nervous system that operates gastrointestinal function called the “enteric” nervous system, we have a neurotransmitter called serotonin that assists in the operation of gut function in terms of motility, sensation and mucosal secretion. Research has found that genetic polymorphisms (or genetic tweaks) may influence the amount of serotonin bioavailability in the gut. For example, too much serotonin may influence the patterning of diarrhoea, whereas too little may influence constipation.

History of parasitic infection

Parasitic infection can be harmful if mismanaged, misdiagnosed or mistreated (e.g. overuse or non-specific antibiotic usage). Unfortunately, our invading gut bugs are extremely clever and they create a biofilm around their colony to guarantee their survival in your gut. As mentioned it is paramount to have a diverse and healthy gut microbiome in the first place. Post gut bug infection, if not treated adequately contributes to inflammation and poor gut flora to lower the immune response and causes further digestive issues.

History of digestive tract surgery

Digestive tract surgery such as the removal of the gall bladder can affect bowel function. The gall bladder is responsible for holding the bile acid that is produced in the liver so that once food enters, it can spurt out the bile to digest the fats in the food. Bile also has a ‘laxation’ effect on the bowel, so assist with constipation or a sluggish bowel. Without a gall bladder, the liver ‘drip feeds’ the bile, rather than holding it in a concentrated form to be released under the stimulus of digestion.

How can naturopathy help IBS?

Naturopathic protocols are individualised and formulated based on subjective and objective information gathered. The aim is for the treatment protocol to be finely tuned, considering all potential influences of the condition. A thorough history is taken to identify the major areas of concern. Further testing may be required – for example to identify food intolerance/ allergy; or to measure the stress response. Dietary and lifestyle recommendations form the foundation of the treatment plan, with nutritional and/or herbal medicine prescription to provide relief from symptoms and to improve quality of life.

Megan Taslaman is a Naturopath and Remedial Massage Therapist at the Lotus Centre available Mon, Tues, Thurs, Fri by appt.