Soothe Irritable Bowel Syndrome

Antispasmodic herbs and more to help ease this common condition.

| March/April 2008

Bloating. Abdominal discomfort. Diarrhea or constipation. Irritable bowel syndrome (IBS) certainly is no fun, but in industrialized nations, it affects 10 percent to 15 percent of the population—about 30 million Americans. It’s the most common functional gastrointestinal disorder, in which the bowel looks normal but functions abnormally. Specifically, the large bowel contracts too much and in a disorganized fashion. IBS more frequently plagues women than men.

Doctors diagnose the condition based on a patient’s reported symptoms. Although there is no test for IBS, tests might be run to exclude other diseases, such as lactose intolerance, pancreatic insufficiency, celiac disease, parasitic infection and bacterial overgrowth of the small intestine. Multiple factors can contribute to the development of IBS: childhood trauma, psychological stress, intestinal infection and inflammation, altered intestinal bacteria, disturbances in nerve and hormone function, food sensitivities and allergies.

Conventional medical treatment includes antidepressants (to relieve accompanying anxiety, depression and pain); antispasmodics to relieve pain and bloating; drugs that modulate intestinal serotonin; opioids for severe pain; drugs like Imodium (loperamide) for diarrhea; fiber and laxatives for constipation; and a short course of antibiotics for intestinal bacterial overgrowth. In a 2004 review of drug management of IBS published in the International Journal of Clinical Practice, the authors say, “The therapeutic management of the irritable bowel syndrome (IBS) is ineffective and not satisfying either patients or practitioners.” After describing new medications, they added, “Questions remain whether a single therapy is sufficient in the management of IBS because this disease is influenced by biological and psychological as well as cultural and social factors.”

Patrick Hanaway, M.D., is the chief medical officer of Genova Diagnostics in Asheville, North Carolina, and the author of several articles on IBS. Hanaway believes the key to successful treatment requires a holistic evaluation and treatment approach. In other words, no magic bullet cures IBS. A practitioner must help identify which of the many disturbances in bowel function underlies a person’s IBS symptoms, then formulate a treatment protocol that restores balance. And healing is attainable. According to Jillian Stansbury, N.D., chair of the botanical medicine program at the National College of Natural Medicine in Portland, Oregon, “IBS is a condition that responds very well to complementary and alternative therapies.”

Diet for a Calm Colon

Stansbury notes that a subset of people with IBS have underlying food allergies. Her tip-off is that the person also has a history of asthma, eczema or hay fever. Hanaway recommends testing for food allergies and sensitivities with either a blood test or an elimination-challenge diet. In the latter, you have to eliminate potentially allergenic foods from the diet (e.g. milk, wheat, eggs, nuts, peanuts, shellfish, soybeans and oranges). Because it takes time for the bowel to recover from the inflammation caused by food intolerance, Stansbury encourages her patients to stay off allergenic foods for two months before the challenge of reintroducing foods one at a time and observing reactions.

Some foods aren’t allergenic but still can provoke IBS symptoms. They include caffeine, alcohol, fatty foods, gas-producing vegetables (legumes and cruciferous veggies), fructose and sorbitol (sweeteners in many beverages, foods and candies). Keeping a food diary will help you identify culprit foods and food additives.

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