Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is a functional disorder in which the large intestine or colon, fails to function properly.

IBS has characteristic symptoms that can include a combination of any of the following:

Abdominal pain and distension; more frequent bowel movements with pain or relief of pain with bowel movements; constipation; diarrhea; excessive production of mucus in the colon; symptoms of indigestion such as flatulence, nausea, or anorexia; and varying degrees of anxiety or depression.

The causes for IBS are not completely clear; physical and emotional issues, as well as dietary factors or irritants have all been linked to this condition. Possible treatment considerations for IBS include increasing dietary fiber, eliminating allergic/intolerant foods, addressing the possible contribution of emotional components, and incorporating nutritional therapies. In many cases, IBS can be controlled by managing diet, lifestyle and stress.

Nutrition Guidelines

• Eat at regular times. Try not to skip meals or go long periods of time without food. The emptier your stomach, the more sensitive it may be.
• Try to limit “stand-up, eat-on-the-run” type meals.
• Chew thoroughly and eat at a leisurely pace – if you must eat in a hurry, only eat a small amount at a time.
• Eat a balanced and varied diet.
• Gradually increase your intake of fiber.
• When your stomach is empty, eat soluble fiber foods first. Make soluble fiber foods a large component of each meal (see fiber sources below).
• Drink plenty of fluids, especially water (at least 6 - 8 glasses a day).
• Eliminate all red meat, dairy, fried foods, egg yolks, coffee, soda, and alcohol from the diet. These are the most common triggers of IBS.
• Limit foods that you are sensitive to or do not tolerate well. Possibilites include dairy products, chocolate, eggs, and wheat products.
• Limit foods high in fat. If you know you will be having high-fat foods, eat a source of soluble fiber first – never eat high fat foods on an empty stomach.
• Eat green salads at the end of the meal (small portions with non-fat dressing).
• Fibers are substances in plant foods that we do not digest and are useful in normalizing bowel function. The two main types of fiber are soluble and insoluble fiber.
• Soluble fibers are commonly found in fruits (especially pears, apples, and citrus), oats, barley and legumes. These water-soluble fibers form gels that provide beneficial effects.
• Insoluble fibers are commonly found in wheat bran, corn bran, whole grain breads and cereals, as well as vegetables. Insoluble fiber has the effect of preventing constipation.

Fiber functions like a sponge by attracting water into the digestive tract, softening stools and preventing constipation. On the flip side, fiber is also useful for adding bulk to the stool which is helpful when diarrhea is present.

Bitter foods can improve the whole upper digestive system’s function and enhance the absorption of nutrients. Try adding some bitters to meals, which include chicory, endive, radicchio, and dandelion greens.

Herbal and Nutritional Supplements have been shown in research studies to be helpful in the treatment of IBS.

• Enteric coated peppermint oil capsules are used to inhibit intestinal contractions and relieve abdominal pain and gas.
• Chamomile and valerian aid in decreasing gas.
• Slippery elm soothes the intestinal lining and decreases inflammation.
• Lemon balm decreases intestinal cramping and spasms.
• Nutritional supplements such as glutamine, beta-carotene, and zinc aid in the healing of the intestinal lining.

Food allergies and intolerances have often been linked to the symptoms experienced by patients with IBS. Roughly two thirds of patients have some type of food intolerance or allergy. Therefore, it is imperative that patients address these causes and eliminate the offending agents. Talk to your nutritionist about identifying potential food allergens through a process known as “the elimination diet.”

Lifestyle Guidelines

• Exercise regularly – 30 to 60 minutes of moderate exercise every day.
• Daily practice of yoga, Tai Chi, or meditation can significantly reduce stress-related symptoms.
• Pay attention to your body’s signals. When you feel the urge to move your bowels, take the time to do so.
• Make sleep a priority – inadequate sleep reduces the body’s ability to manage stress effectively.

Emotional Components such as depression, insomnia, fatigue, and anxiety are often associated with IBS sufferers. Increased contractions of the colon have been shown to occur in patients with IBS in response to stressful situations, which can lead to uncomforatble symptoms.

Various methods of treatment that may be helpful to reduce stress, anxiety, depression, and fatigue include biofeedback, individual counseling, guided imagery, and physical activity. If necessary, seek the help of a professional to manage stress or other emotional factors.

It is important to determine the cause of any intestinal complaint; therefore infectious or other causes of bowel symptoms must be ruled out prior to diagnosis of IBS. Once a diagnosis of IBS has been made, know that stress and emotional factors weigh heavily in the equation and should be addressed as part of treatment.

IBS Resources
Eating for IBS
www.eatingforibs.com

IBS Self Help Group
www.ibsgroup.org

Eating for IBS: 175 Delicious, Nutritious, Low-Fat, Low-Residue Recipes to Stabilize the Touchiest Tummy, by Heather Van Vorous. Marlowe & Co., 2000.

Be Good to Your Gut: Recipes & Tips for People with Digestive Problems, by Pat Baird, MA, RD. Blackwell Science, Inc., 1996.

References:
Eating for IBS www.eatingforibs.com
Dr. Michael T. Murray Online www.drmurray.com
Mayo Clinic www.mayoclinic.com
“IBS: Suffering in Silence” by Krista Fuller. Today’s Dietitian, February 2003.

Dr. Nicole Sundene, NMD is a licensed Naturopathic Medical Doctor at Fountain Hills Naturopathic Medicine 16719 E Palisades Blvd, Suite 205, Fountain Hills, AZ 85268.

She believes we should utilize natural medicines to treat the root cause of disease rather than just treating symptoms, as symptoms are a message of imbalance sent from the body and will persist until they are properly addressed.

For appointments please visit http://FHnaturopathic.com for more information about Naturopathic Medicine services.
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