Irritable Bowel Syndrome (IBS)
What is Irritable Bowel Syndrome (IBS)?
Irritable bowel syndrome is a common digestive problem characterised most often by bloating, abdominal pain, flatulence, constipation and/or diarrhoea. It is defined as a benign, chronic disease and is sometimes considered to be a functional type of bowel disorder that is caused by heavy, muscular spasms in the colon (large intestine). IBS can cause people to miss work and social events, and there is often some associated anxiety and/or depression. Sometimes people find that their symptoms subside for a few months and then return, while others report a constant worsening of symptoms over time. The majority of sufferers are women and most have their first symptoms between the ages of 15 and 40.
What causes IBS?
When the word 'syndrome' is used in medicine it indicates an umbrella term for a range of symptoms with no single, clear cause. One theory is that people who suffer from IBS have a colon (large intestine) that is particularly sensitive and reactive to certain foods and stress. The immune and nervous systems may play a central role in the development of this condition as there are many neurological (nerve) and hormonal connections between the brain and the gut. It is often the case that psychological and emotional factors can trigger neural and hormonal changes that cause an inflammatory response.
IBS may also be linked to small intestinal bacterial overgrowth (SIBO), a condition where abnormally large numbers of bacteria are present in the small intestine. These types of bacteria can have a similarity to those more commonly found in the colon and are considered to establish an imbalance in the gut. Any condition that interferes with muscular activity in the small intestine allows the bacteria to remain longer and multiply. Reduced muscular activity may also allow bacteria to spread backwards from the colon and into the small intestine.
The transit time of fluids through the gut is determined by peristalsis (muscular movement), bowel wall integrity and other factors. As already noted, transit time is very significant and affects the quantity and quality of fluids absorbed into the blood supply with significant repercussions for overall health. Malabsorption of sugars and carbohydrates in the small intestine caused by rapid transit time allows increased amounts of sugar and carbohydrate to reach the colon where greater amounts of gas are produced.
It may also be the case that a lack of pancreatic and intestinal enzymes which help to break down carbohydrates can allow bacteria to react with these carbohydrates (ie lactose - sugar found in milk) causing pain, bloating and gas.
Some research states that IBS may be caused by a bacterial infection in the gastrointestinal tract. Studies show that people who have had gastroenteritis sometimes develop IBS, otherwise called post-infectious IBS. Researchers have also found very mild coeliac disease in some people with symptoms similar to IBS. People with coeliac disease cannot digest gluten, a substance found in wheat, rye, and barley.
Other research suggets that serotonin is linked with normal gastrointestinal (GI) functioning. Serotonin is a neurotransmitter, a chemical that delivers messages from one nerve cell to another, and 95% of the serotonin in your body is located in the GI tract while the other 5 percent is found in the brain. It functions to regulate appetite, sleep, memory, learning, temperature, mood, behaviour, and muscle contraction. It may also have a role in depression as some depressed patients are seen to have lower concentrations of metabolites of serotonin in their brain tissue and cerebrospinal fluid. Cells that line the inside of the colon work as transporters and carry the serotonin out of the GI tract. People with IBS, however, have diminished receptor activity that causes abnormal levels of serotonin to exist in the GI tract. As a result, people with IBS experience problems with bowel movement, motility, and sensation—having more sensitive pain receptors in their GI tract.
Researchers have also found that women with IBS may have more symptoms during their menstrual periods, suggesting that reproductive hormones can worsen IBS problems.
IBS Treatment
Various different approaches may be required but people can often overcome this condition with an appropriate individual treatment plan that might include acupuncture, diet, herbal medicine, massage, stress management and prescribed medications.
