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JT 19 December 2013

HEALTH

Alternative Treatments
IRRITABLE bowel syndrome (IBS) is a chronic gastrointestinal disorder characterized by altered bowel habits (diarrhoea and/or constipation) and often-severe abdominal pain, bloating and gas. According to most Western medical literature IBS is a chronic disorder of unknown cause. Irritable bowel syndrome (IBS) is the most common gastrointestinal disorder. As well, IBS is one of the most common medical problems seen by GPs and accounts for up to 12% of total visits to primary care providers. Since IBS is such a common problem, I thought it was important to discuss the many clinically proven alternative medical treatments naturopathic medicine has to offer people with IBS. How is IBS diagnosed? IBS is a diagnosis of exclusion given by medical doctors when it is clear that a patient does not have a more serious gastrointestinal problem like Irritable Bowel Disease (Crohns or Ulcerative Colitis), Coeliac disease or a dysenteric infection. Once more serious possibilities are ruled out, a person will likely be given the catch-all diagnosis of Irritable bowel syndrome (IBS). Is IBS real or all in the head? There is clear evidence that IBS is real. Research has shown there to be measurable differences between a person with IBS and a person without it: Low grade inammation: Irritable bowel syndrome patients show no identiable inammation when samples of their colonic tissue is looked at under the microscope. However, some people do show increased production of inammatory chemicals suggesting low grade inammation is present but not seen. Altered gastrointestinal tract motility: Studies have shown that there are signicant delays found in the mechanisms involved with the movement of food through the digestive tract in people who suffer from IBS. Altered Bacteria in the gut: Studies have found patients with IBS produce signicantly more hydrogen in their stomachs than people without IBS. The colonies of bacteria found in IBS patients have less good bacteria such as bidobacteria and lactobacilli and higher concentrations of the bacteria enterobacteriacae. Enhanced Internal Stomach Perception: Patients with IBS have been found to have more awareness of sensations in their guts than people without IBS. Are some people more at risk than others for developing IBS? The following are a few risk factors that have been shown to increase the likelihood of acquiring IBS. Genetic: It has been shown that people have a genetic predisposition to acquiring IBS. IBS is not predisposed by having a parent with IBS, but by having a parent with alterations in their nervous systems response to external stimuli. Previous Gastrointestinal Infection: It appears that about 10% of people with IBS acquired it following an episode of dysentery.

for IBS

Dr Anders Nerman ND
Has been shown to signicantly lessen the constipation associated with IBS. It also relieves stress and improves mood. Herbal Medicine: There are many herbs that are very helpful for the treatment of IBS. Some are used to help stop the diarrhoea or alternatively to increase motility or act as a laxative in constipation. Others herbs help soothe the digestive tract in general. It is also possible to use herbs that help deal with stress by supporting the nervous system, which can decrease the intensity of the IBS symptoms. A proper herbalist or Naturopathic Doctor trained in herbal prescribing can come up with the right formula to manage the symptoms of IBS for each individual case. Special Herbal Note: Tumeric Turmeric, the common spice, acts as an anti-inammatory agent in the gut. Turmeric, in particular, was found to signicantly reduce abdominal pain and discomfort in IBS. Diet: It is not surprising that people who come to me with IBS want to know if a food they are consuming might have some inuence on the IBS symptoms. Many people know already that their signs and symptoms worsen when they eat certain foods. The verdict is not out on the role of food intolerance in irritable bowel syndrome. From my clinical experience, however, and the clinical experience of many practitioners in my profession, it is clear that eliminating problem foods from ones diet is essential in the treatment of IBS. There are good blood tests (IgG Antibody Food Intolerance Blood Tests) that can help a person nd their problem foods by identifying which foods their bodies are having an immune response to. I use this test on a daily basis with my patients in my practice in Jerusalem. Stress Reduction: Deep breathing exercises and certain types of meditation are all good ways to reduce stress which lessens the severity of IBS. IBS is one of the most common complaints seen in a doctors surgery and yet it is one of the least understood problems. Western medicine offers very little in the way of solutions to this problem and the pharmaceutical drugs given have very little effect and produce adverse side effects. As noted, there are lots of evidence-based, clinically-proven alternative treatments to IBS. If you have IBS maybe it is in your best interest to try some of the many natural alternatives available to help you resolve this issue once and for all!

Antibiotics use: Two studies have found an association between antibiotic use and increased frequency of IBS symptoms. This may be because the antibiotics altered the gut bacteria or that the antibiotics caused damage and inammation to the gut lining. Stress: Stress and traumatic life events have frequently been reported to have preceded the initial onset of IBS symptoms and symptom are-ups in patients suffering from IBS. Additionally, IBS has consistently been found in patients with depression, panic disorders, and generalized anxiety disorder. What do Western doctors do for IBS? Many agents are currently being used in Western medicine for the treatment of IBS and no one agent has been proven particularity effective. The therapeutic gain (difference in treatment response between placebo and the active therapy given) has been minimal with these agents. As well, there are adverse side effects to many of the drugs given and therefore it is worthwhile to investigate natural medical treatments as a possible alternative to pharmaceutical agents. What alternative solutions to IBS are there? Probiotics: As mentioned above, there has been shown to be colonies of abnormal gut bacteria in the intestinal tracts of people with IBS. This is occasionally due to heavy antibiotic use where the concentrations of benecial bacteria decrease and the numbers of harmful bacteria rise. Bad bacteria cause gas and putrefaction of food, and diarrhoea. Therefore one of the key therapies now being regularly employed in the treatment of IBS is the use of probiotics (good bacteria). Probiotics which contain good bacteria such as lactobacillus acidophilus are a useful choice in IBS as was shown in studies as early as 1955. A systematic review and meta-analysis of randomized, controlled trials found probiotic use to be associated with improvements in IBS symptoms compared to placebo and to produce a real reduction in abdominal pain. Efcacy in IBS has been shown to be dependent on the type of bacterial strain. L. fermentum and l. plantarum are two strains that have shown in studies to be very helpful in IBS. Where can I get Probiotics? Fermented foods (yogurt, kim chi and sauerkraut) are a great natural source of probiotics. One can also simply take probiotics in capsules, tablets and powder form. In my opinion, powder form probiotics are the most effective for results in IBS as they work in the upper intestinal tract, dont have binders, and can be incorporated into food and drinks easily. Unfortunately, they have a much higher cost than fermented foods. Fibre: A recent systemic review and meta-analysis found bre to signicantly improve IBS symptoms especially in IBS where constipation is the predominant symptom. Note, however, that it did increase abdominal pain somewhat. Soluble bres like ground axseeds, slippery elm powder, psyllim husks, and oat bran have been found to be most effective. Fluid intake: Adequate uid intake is very important in the treatment of IBS. This would be 2-2.5 litres of water/uid a day. Exercise:

T h e author is a Naturopathic Doctor with an Integrative Family Medical practice in Wolfson Medical Centre in Jerusalem, Israel. For more call 00972-54-427-8667. Information is provided for informational purposes only and is not intended as a substitute for the advice provided by your physician or other healthcare professional. Always speak with your physician or other healthcare professional before taking any medication or nutritional, herbal or homeopathic supplement, or adopting any treatment for a health problem.