Natural Approaches to Irritable Bowel Syndrome (IBS)
~ Life Extension Magazine, Relief From Irritable Bowel Syndrome (2015)
It is estimated that at least 20% of the American population has IBS. If you suffer from chronic digestive disturbances, your healthcare practitioner may conclude from your medical history and a physical exam that you have this painful and potentially debilitating condition. If you would rather not merely mask or suppress your symptoms with standard medical therapy, you may want to consider certain natural treatments that can address the major biological changes that contribute to them.
Symptoms & Causes
IBS is a poorly understood gastrointestinal disorder that is characterized by some combination of chronic intestinal cramping, abdominal pain, bloating, gas, feelings of fullness, excess secretion of colonic mucus, diarrhea, or constipation, that lasts for at least three months. It is generally diagnosed through the elimination of other conditions that can cause similar symptoms, including cancer, parasitic infections, intestinal disturbance from antacid or laxative abuse, inflammatory bowel, diverticular, and celiac diseases, ulcerative colitis, and metabolic disorders (adrenal fatigue/diabetes/hyperthyroidism).
The recognized IBS risk factors are: youth (occurs most in those under age 50); female gender (and menopausal estrogen therapy); family history (both genetic and environmental factors); and mental health problems (anxiety, depression, history of abuse). Hormonal changes, unmanaged stress, and food allergies or intolerances, are key triggers that can cause or exacerbate IBS.
While IBS is not a serious threat, there are five major interconnected biological changes that together contribute to its symptoms, regardless of cause, which can greatly impair quality of life: (1) altered intestinal muscle contractions that cause abnormal movement of food through the intestines (motility); (2) intestinal hypersensitivity resulting in intense pain response (see the quote above); (3) low-grade inflammation in intestinal walls from the presence of increased immune cells; (4) leaky gut and food sensitivities; and (5) imbalance of intestinal microflora (dysbiosis). To fully address IBS, it is ideal to address all five of these processes simultaneously.
Therapeutic Dietary Considerations
Some people can control their IBS symptoms by managing stress, lifestyle, and diet. In addition to exploring counseling, biofeedback, mindfulness training, and ways to improve sleep quality, it makes sense to address these dietary factors that have been found to exacerbate IBS:
FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols): Since these short-chain carbohydrates are poorly absorbed in the small intestine, small intestinal bacteria tend to ferment them, thereby generating large amounts of gases that cause bloating. Curbing intake of these types of carbohydrates, and the foods containing high amounts of them, can thus be instrumental in curbing IBS symptoms in most patients: (1) fructans (wheat, onions, artichokes) [inulin, fructooligosaccharides (FOS), called prebiotics, which feed good gut bacteria]; (2) galactans (legumes, cabbage, Brussels sprouts); (3) lactose (milk sugar, found in dairy products, chocolate and other sweets, beer, and processed foods); (4) fructose (fruit sugar, found in honey and agave syrup, and regular and dried fruit); and (5) sugar alcohols (sorbitol, xylitol, mannitol, and erythritol).
Food Allergies/Intolerances: Food allergies and sensitivities have long been associated with IBS. The biggest culprits include foods rich in carbohydrates and fats, dairy, grains (especially wheat), coffee, alcohol, and hot spices. An IgG blood test, elimination diet, and probiotic supplementation, can generally address IBS symptoms associated with food intolerance.
Sugar: Consuming high amounts of refined sugars can exacerbate both IBS and small intestinal bacterial overgrowth (SIBO). Excessively high levels of blood glucose paralyze the duodenum and jejunum of the small intestine, thus decreasing motility.
Yeast: Candidiasis is an overgrowth of the parasitic, yeast-like fungus Candida albicans, which is normally present in the body. Since this condition may be an underlying factor in IBS, an anti-candida program can prove therapeutic. Such a program focuses on: (1) killing the yeast (with dietary supplements or anti-fungal drug like Nystatin); (2) starving the yeast with a strict low-sugar/carbohydrate diet; and (3) replacing the displaced good gut bacteria with probiotics.
Key Supportive Dietary Supplements
With the diet modifications noted above, a number of natural remedies may be viable alternatives to conventional, often ineffective IBS prescription drugs, such as antispasmodics, antidepressants, and antidiarrheals.
Aloe Vera Juice: Although few studies have investigated the efficacy of aloe vera specifically in the treatment of IBS, it is generally known to improve bowel regularity. Since aloe soothes and heals the intestines, detoxifies, and inhibits the growth of yeast in the gut, it may reduce abdominal pain/discomfort and flatulence in IBS patients suffering primarily from constipation.
Fiber: In most IBS cases, especially where constipation predominates, non-wheat, moderately fermentable sources of soluble fiber can ease symptoms. The most supportive sources include vegetables, low-sugar fruits, psyllium seed, and guar gum. Other dietary fibers can exacerbate IBS symptoms.
Since increasing fiber intake can initially cause abdominal bloating/distension and change in the bowel habits of IBS patients, supplementation should be started with a maximum increase of no more than 5 g/day.
Grapefruit Seed Extract (GSE): Although human studies are largely lacking, clinical practice and animal/test-tube studies have established GSE as an antifungal, antiviral, and antibacterial. Its ability to combat Candida albicans is a possible explanation for its effectiveness in one preliminary human study of subjects with IBS and eczema. After one month, all subjects given 150 mg of encapsulated GSE three times per day experienced significant improvements in flatulence, constipation, abdominal discomfort, and even sleep.
L-Glutamine: Researchers in a recent small randomized placebo-controlled trial concluded that this amino acid can dramatically and safely reduce all IBS symptoms in patients with diarrhea-predominant IBS that develops after intestinal infection. Despite their finding that L-glutamine can address intestinal hyperpermeability (leaky gut syndrome), the researchers recommended that larger clinical trials be conducted to assess more fully its pharmacological mechanisms and ability to improve quality of life.
Peppermint Oil (Enteric Coated): Some studies have shown that this remedy, when 0.2 – 0.4 ml is taken 2-3 times per day between meals, reduces irritation, intestinal cramping and spasm, and gas production. Peppermint oil, especially when combined with clove oil, also combats candidiasis.
Perilla Leaf Extract with Saccharomyces Cerevisiae (Brewer’s Yeast): This herbal-probiotic combination can reverse or reduce all five of the major factors mentioned above that can produce the various IBS symptoms. Perilla leaf is antispasmodic, anti-inflammatory, and prokinetic (promotes normal motility, strengthens the lower esophageal sphincter, and controls acid reflux). Animal and simulated human studies have demonstrated that a particular strain of S. cerevisiae (CNCM I-3856) reverses dysbiosis by reducing the presence of harmful bacteria such as E. coli.
Probiotics: There is ample scientific evidence that greater diversity of gut bacteria produces overall better intestinal and general health. While introducing these beneficial live bacteria into the intestines helps with some IBS symptoms, they are not likely to resolve all of them. Studies have proven various combinations of lactobacillus and bifidobacterium strains are highly supportive, particularly the strains B. infantis, L. rhamnosus, and L. plantarum [especially extensively documented L. Plantarum 299v (LP299V®)]. Multi-strain products that provide a minimum of 5-20 Billion bacteria per dose, up to 50 – 90 Billion as needed, can best support IBS sufferers.
Given that IBS is so poorly understood, and the poor track record of IBS medications, it makes sense to explore various combinations of these natural remedies.
The statements in this article have not been evaluated by the Food and Drug Administration, are for educational purposes only, and are not intended to take the place of a physician’s advice.
Submitted by Erika Dworkin, Board Certified in Holistic Nutrition®, Nutrition Consultant and owner of the Manchester Parkade Health Shoppe (860.646.8178), 378 Middle Turnpike West, Manchester, CT, www.cthealthshop.com, nutrition specialists trusted since 1956. Erika is available to speak to groups.
All statements in this article are evidence-based and references are available upon request.