Irritable bowel syndrome (IBS) is one of the most common and most annoying, painful problems in modern society.
If you suffer from it then you will have found little long-term help from your doctor and it can be years before there is any solution, if at all.
This is because the causes are very complex, poorly understood and difficult to treat with conventional drugs.
In this article we are going to briefly outline the symptoms, statistics and proposed causes, then provide you with some potential natural solutions.
Diagnostic criteria for irritable bowel syndrome (IBS) include recurrent abdominal pain or discomfort at least 3 days per month in the past 3 months associated with two or more of the following:
- Improvement (Pain reduction) with defecation;
- Onset associated with a change in the frequency of stool;
- Onset associated with a change in the form (appearance) of stool; and/or
- Criteria fulfilled for the past 3 months with symptom onset at least 6 months before diagnosis.
Discomfort means an uncomfortable sensation not described as pain. During screening evaluation, pain or discomfort frequency must be at least 2 days per week to qualify subjects for clinical trials. (1)
It is well established that Irritable Bowel Syndrome (IBS) symptoms give feelings of shame, fearfulness and embarrassment, while patients also report being misunderstood by their doctors, their family members and friends. (12)
You can see in this chart just how common the problem is worldwide.
To mention just a few, 15-19% of New Zealander's, 10-14% of British and 5-9% of Americans and Australians are affected. It is interesting how less than 5% of Chinese and Indian people have IBS while Mexicans are over 30%. The obvious question here is has this got something to do with local dietary habits?
POTENTIAL CAUSES OF IRRITABLE BOWEL SYNDROME
Although the cause of irritable bowel syndrome (IBS) has not yet been completely understood, multiple factors appear to have a role, including composition of the gut micro-flora, intestinal permeability, immune response and the gut-brain connection.
The gastrointestinal microflora is a diverse and numerous ecosystem that inhabits the entire gastrointestinal tract and has a systemic influence on our health. Associations were observed between patients self-reported symptoms and the presence or quantities of certain gut bacteria. Among IBS subjects several gut bacterial strains were significantly reduced. (4)
Microflora activity mirrors differences between herbivorous and carnivorous mammals, reflecting trade-offs between carbohydrate and protein fermentation. Foodborne microbes from both diets transiently colonized the gut, including bacteria, fungi and even viruses. These results demonstrate that the gut microflora can rapidly respond to altered diet. (6)
An imbalance of intestinal microflora and/or the presence of unwanted fungi, bacteria and viruses can disrupt the sensitive mucous membrane of the gut.
On one hand, an intact intestinal barrier protects the human organism against invasion of microorganisms and toxins, on the other hand, this barrier must be open to absorb essential fluids and nutrients. Such opposing goals are achieved by very complex anatomy and physiology. The intestinal barrier represents a huge mucosal surface, where billions of bacteria face the largest immune system of our body. (3)
In one study the permeability of colon tissue samples was found to be significantly higher in patients with IBS compared to healthy subjects. (5)
This may be caused to disturbances to the microflora which in turn may have triggered an inflammatory immune response.
Infectious gastroenteritis is the strongest risk factor for the development of IBS and increased rates of IBS-like symptoms have been detected in patients with inflammatory bowel disease in remission or in celiac disease patients on a gluten free diet. The number of immune cells in the small and large intestine of patients with IBS is increased in a large proportion of patients. (2)
Supporting the immune system and microflora of the gut may be of assistance, improving digestive processes while simultaneously reducing gut inflammation.
The gut-brain connection
The brain, the gut, its microflora and the immune system present two way communications in health and disease. The brain, via the nervous system, influences intestinal motility and fluid secretion (8), intestinal permeability (3), immune function (10) and gut microflora (11), all of which have been reported to be out of control with IBS.
The mental and emotional connection to the digestive system is powerful and must be considered in the context of IBS.
Technically known as the enteric nervous system, the second brain consists of sheaths of neurons embedded in the walls of the long tube of our gut, or alimentary canal, which measures about nine meters end to end from the esophagus to the anus. The second brain contains some 100 million neurons, more than in either the spinal cord or the peripheral nervous system, technically known as the enteric nervous system. (16)
The enteric nervous system uses more than 30 neurotransmitters, just like the brain, and in fact 95 percent of the body's serotonin is found in the bowels. Irritable bowel syndrome also arises in part from too much serotonin in our entrails, and could perhaps be regarded as a "mental illness" of the second brain. (16)
COMMON ALLOPATHIC TREATMENTS (mainstream treatments)
The most commonly prescribed drugs for IBS include laxatives, antibiotics, anti- diarrhoeals and anti-depressants.
All of these drugs may provide some temporary relief of symptoms but none offer a long term solution by way of treating the cause of the problem. The underlying dietary habits, general gut health and mental status may not have been resolved.
This is where natural solutions come into their own.
When looking at a complex multi-faceted problem like IBS conventional treatments often work short-term but fail to provide long term relief. This is because the problem can be subtle and lie largely within the realm dietary, nutritional emotional and mental systems.
The areas of gut microflora, intestinal permeability, immune response and gut brain connection all fall into strong categories for natural solutions.
Let's look at each of these individually
Diet has a marked impact on gut microbflora diversity, understandable given that resident micro‐organisms obtain energy for growth via metabolism of dietary nutrients. (13)
The effect of dietary fiber consumption on the intestinal microflora composition, was reported from global population studies with very similar results. Using recent and long‐term dietary questionnaires and stool samples from healthy human subjects, microflora analysis demonstrated that diet low in fat and high in dietary fiber was associated with higher positive bacteria, but diet high in fat was more highly associated with negative bacteria.
There has been growing concern that even short‐term dietary changes, particularly to a ‘Westernised’ style diet (high animal fat, high sugar and low in plant‐based fiber) can rapidly alter the composition and metabolic activity of resident intestinal microflora, with decreased levels of beneficial bacteria and increased numbers of bile‐tolerant, inflammation‐associated bacteria (13)
Some of the pre-biotic herbs traditionally used to encourage healthy microflora and reduce negative bacteria and parasites include:
Click on the herbs to find out more
The introduction of Lactobacilli and Bifidobacteria in high dose supplement form or enema may also be useful in the short term, especially where a gut brain connection is suspected. (14)
In a recent pilot study of elderly persons, the intestinal load of the positive bacteria lactobacilli was linked to the count of white blood cells, blood glucose and LDL cholesterol, all risk markers of inflammation, metabolic syndrome and cardiovascular disease. (15)
Using plain unsweetened acidophilus yogurt in smoothies on a regular basis can be of great assistance.
See our Probiotic smoothie recipes here
The gut barrier plays a key role in the avoidance of inflammatory responses to the microflora and is regulated by a finely tuned network of immune mechanisms (3) Because increased intestinal permeability and inflammation go hand in hand, natural methods to reduce intestinal inflammation will be useful.
A diet rich in plant and vegetable fiber has shown to greatly reduce inflammation. A recent demonstration from the Nurses Health study that subjects had 50% lower risk for the development of Crohn's disease, which was directly associated with long‐term ingestion of a diet rich in fruit and vegetable fiber. (13) The Herbal Detox diet plan promotes a pure fruit and vegetable diet and has been reported to assist with IBS.
Powerful triggers for inflammation are the presence of microorganisms in sites where they do not belong. Microorganisms contain structures alien to the body. Bacteria and fungi, for example, have cell walls in contrast to human cells that lack these structures, and viruses have unique forms of DNA and RNA. Cells and molecules involved in the inflammatory defense system react immediately against these foreign elements; they are danger signals to the body. (15)
Again this points to supporting the microflora, as above, which also introducing anti parasitic, antifungal and anti-inflammtory agents.
Traditional herbal remedies include:
Herbal Teas to reduce inflammation and intestinal permeability:
Try a mixture of these three teas in your teapot and drink 2-3 cups daily.
The intestinal immune system has developed a tightly regulated control to optimize the protection against pathogens, while at the same time avoiding unnecessary immune activity. (15)
Supporting the entire immune system along with pre-biotics and probiotics will be the best approach.
You can use foods to do this:
Mushrooms - which boost our immunity;
Garlic - high in sulfur which boost immunity;
Vitamin C foods - anything fresh will contain Vitamin C;
Colloidal silver - Antimicrobial; and
Aloe vera juice - 50ml daily.
The gut-brain connection
Going back to the brain gut connection, there is an important role for the nervous system to play in IBS. Meditation can play a major role here.
One randomized controlled trial demonstrated that mindfulness training has a substantial therapeutic effect on bowel symptom severity, improves health-related quality of life, and reduces distress. (7)
Interestingly, changes in quality of life, psychological distress, and visceral anxiety were not significantly different between groups immediately after treatment, but evidenced significantly greater improvements in the meditation group at the 3-month follow-up. (7)
This makes sense, as the effects of meditation are known to increase over time.
Irritable bowel syndrome Dietary advice
There is a lot of theories on dietary advice for IBS but nothing that is conclusive or that can applied to everybody.
Some things seem fairly obvious when you look at the research. Inflammatory foods, lack of pre-biotic containing fruits and vegetables and low fiber intake must all be factors.
Foods to Avoid
Irritating food for the digestive system, includes the following:
Processed foods in general (including pasta)
Processed grains especially wheat, and other products containing gluten, pasta, pastry, cake etc.
Too many nuts and legumes like baked beans, chickpeas and lentils
Gas forming foods - Raw cabbage, cauliflower, broccoli
Plus don't follow a raw food salad diet until the IBS symptoms have gone
Eat plenty of fruit and vegetables (try stewed apples)
Cooked root vegetables (except potatoes)
Vegetable Soups, mushroom, pumpkin, parsnip
Chicken and fish (instead of red meats)
Probiotic drinks and yogurt smoothies
Digestive herbs and mild-medium spices especially turmeric, mint, cinnamon, rosemary
Black tea and herbal teas (see above)
Follow this with Colonaid and Digezaid capsules, 4 of each daily for one month.
Complete this program twice a year to maintain a healthy digestive system
Follow up Plan
I would recommend continuing with the dietary advice until IBS symptoms have been absent for over 3 months, preferably 6 months, then gradually introducing foods as you feel comfortable.
Long term it would be best to minimize the inflammatory, acid forming foods mentioned and keep up the good food and herbs.
It is always good to complete a Herbal Detox at least once a year and you can also use our other herbal products to continue your journey.
The Ultimate Herbal SLIM – To achieve your ideal weight
BodiTune Drink or Boditune Capsules – To help maintain a healthy and regular digestive systemYou can see some comments below from IBS sufferers who have completed our program.
I hope this article has been helpful and please share your comments if you also find success with our recommendations.
Brett Elliott ®
(1) Longstreth, G. F. et al. Functional bowel disorders. Gastroenterology 130, 1480–1491 (2006).
(2) The immune system in irritable bowel syndrome. PUBMED http://www.ncbi.nlm.nih.gov/pubmed/22148103?dopt=Abstract&holding=npg
(3) Intestinal permeability--a new target for disease prevention and therapy. PUBMED http://www.ncbi.nlm.nih.gov/pubmed/25407511?dopt=Abstract&holding=npg
(4) Association of symptoms with gastrointestinal microbiota in irritable bowel syndrome. PUBMED http://www.ncbi.nlm.nih.gov/pubmed/20857523?dopt=Abstract&holding=npg
(5) Impaired intestinal barrier integrity in the colon of patients with irritable bowel syndrome: involvement of soluble mediators. PUBMED http://www.ncbi.nlm.nih.gov/pubmed/18824556?dopt=Abstract&holding=npg
(6) Diet rapidly and reproducibly alters the human gut microbiome. PUBMED http://www.ncbi.nlm.nih.gov/pubmed/24336217?dopt=Abstract&holding=npg
(7) Mindfulness training reduces the severity of irritable bowel syndrome in women: results of a randomized controlled trial. PUBMED http://www.ncbi.nlm.nih.gov/pubmed/21691341?dopt=Abstract&holding=npg
(8) Functional GI disorders: from animal models to drug development. PUBMED http://www.ncbi.nlm.nih.gov/pubmed/17965064?dopt=Abstract&holding=npg
(10) Stress system--organization, physiology and immunoregulation. PUBMED http://www.ncbi.nlm.nih.gov/pubmed/17709947?dopt=Abstract&holding=npg
(11) Brain-gut microbiome interactions and functional bowel disorders. PUBMED http://www.ncbi.nlm.nih.gov/pubmed/24583088?dopt=Abstract&holding=npg
(12) A focus group assessment of patient perspectives on irritable bowel syndrome and illness severity. PUBMED http://www.ncbi.nlm.nih.gov/pubmed/19337833?dopt=Abstract&holding=npg
(13) Review article: dietary fibre–microbiota interactions. PUBMED http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4949558/
(14) The impact of gut microbiota on brain and behaviour: implications for psychiatry. PUBMED http://www.ncbi.nlm.nih.gov/pubmed/26372511
(15) Gut Microbiota and Inflammation. PUBMED http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3257638/
(16) Think Twice: How the Gut's "Second Brain" Influences Mood and Well-Being. The scientific American http://www.scientificamerican.com/article/gut-second-brain/