Irritable Bowel Syndrome

Irritable Bowel Syndrome/Gut Fermentation

Irritable Bowel Syndrome is the cause of significant ill health in the community in that approximately 20% of the population have symptoms of it, and 50% of patients attending Gastoenterology clinics are diagnosed with it. Common symptoms include bloating, flatulence, diarrhoea, constipation and pain. It can occur in any part of the abdomen, either generalized or local to one specific area.

While bowel symptoms may be the presenting symptoms, patients may also have a wide variety of other symptoms, including muscle pains, hormonal imbalance, increased premenstrual tension, and poor overall energy and well-being.

Q. How is it diagnosed?

A. There is no diagnostic test for irritable bowel syndrome. It is usually diagnosed by exclusion of other illnesses, e.g. ulcers, gall bladder, liver and pancreas, and by the typical symptoms outlined above.

Q. What is Conventional Treatment?

When bowel investigations are normal, patients are generally reassured that there is “nothing serious”. This is welcome, but they are still left with the problem.
Dietary Advice: Fibre rich diets have been traditionally recommended, e.g. All Bran, wholemeal bread, fruit and vegetables. However, a study a few years ago showed that approximately 50% of IBS patients are worse with this, resulting in increased bloating and discomfort.
Medication for symptom relief, including anti-spasmodics, e.g. colofac, motilium, anti-diarrhoea agents, (immodium) and bulk forming agents, e.g. psyllium. These produce only symptomatic, temporary relief.

Q. What causes Irritable Bowel Syndrome?

A. Common precipitating factors include a significant gastroenteritis, frequent antibiotics, stress and food allergy/intolerance. Causes vary in different individuals, but the work of Hunter (a Gastroenterologist in Cambridge) would suggest that 60% of patients with irritable bowel syndrome obtain significant improvement with dietary elimination. Allergy testing is only one aspect of allergy management and this should always be combined with a comprehensive history and evaluation of response to elimination and challenge.

Q. How long to I need to be on the diet to see a response?

A. The good news is that two weeks is often sufficient to clarify the role of diet in the condition. Re-challenging of the omitted foods should be systematic, both to confirm results and avoid strong allergic reactions.

Q. Will I have to keep off these foods forever?

A. No, these intolerances are often temporary and different to highly allergic foods, e.g. peanuts and seafood. Many patients are unwilling to keep on a diet for a prolonged period and other treatments are required to reduce the level of food sensitivity. These measures include Pancreatic enzymes and various preparations to improve the leaky gut/inbalanced gut permeability, which contribute to Irritable Bowel Syndrome.

Q. What is Gut Dyspiosis/Fermentation?

A. This can be a cause of Irritable Bowel Syndrome and broadly involves disturbance of the normal gut bacteria/flora. Diagnosis can be made from the history but further tests, e.g. Gut Permeability and Gut Fermentation may be required to confirm the diagnosis. Candida Syndrome is one cause of this condition. Symptoms of this include sugar craving, poor alcohol tolerance, fungal infections e.g. thrush, athletes foot, dandruff, poor energy and well being as well as irritable bowel symptoms particularly flatulence and bloating. This responds well to a combination of Diet, Supplements and Anti-fungal medication.

Q. Is Stress causing my Irritable Bowel?

A. Stress is undoubtedly an aggravating factor, but it is rarely the only factor. I find that stress has a greatly reduced impact when the underlying cause is corrected. If stress is a particularly strong feature, relaxation techniques, regular exercise and perhaps hypnosis, can be of benefit.

Q. Will I ever be rid of my Irritable Bowel Syndrome?

A. Yes. In general IBS is a condition that responds well to treatment. The natural history is for it to improve with age.

Q. Can Acupuncture help?

A. Our digestion is very much under nervous system control. Not surprising, Acupuncture can be helpful either alone or in conjunction with other treatments.