Managing Irritable Bowel Syndrome (IBS)

Irritable Bowel Syndrome (IBS) ‘is a common, long-term condition of the digestive system. It can cause bouts of stomach cramps, bloating, diarrhoea and/or constipation’ (NHS, 2014). IBS can present itself in different ways: those predominantly experiencing diarrhoea (IBS-D), constipation (IBS-C), alternating between the two (IBS-A) and post-infectious IBS, which begins after an episode of gastroenteritis (IBS-PI).

For some, IBS is a debilitating condition causing considerable abdominal pain on a daily basis, others have symptoms that come and go. Further symptoms commonly include: urgently needing to go to the toilet, flatulence, a feeling of incomplete emptying of the bowels, mucus in the stools, fatigue, backache and an increased need to urinate.

Most people find with considered lifestyle and dietary changes, their IBS become more manageable and improves after a few months to years.

This blog considers the use of herbs and natural supplements in the management of IBS, alongside some lifestyle choices that may help.

stomachspasms

Causes and General Advice

The causes of IBS are not yet fully understood. In a third of cases of people with IBS, it is found that they have food sensitivities (McIntyre, 2006). Studies have shown that the most likely foods causing an allergy or intolerance are grains (especially wheat), dairy products, coffee, tea and citrus fruits. Most NHS practitioners, on diagnosis of IBS, recommend keeping a food and symptoms journal to see whether you can notice a pattern over a period of a 8-12 weeks. You may find careful elimination of certain foods beneficial under the supervision of your GP or a dietitian. If you cannot find a pattern yet still believe there are potential foods sensitivities, there are IgG antibody tests available from organisations such as YorkTest that you may wish to consider. Many people with IBS find that a gluten-free diet improves symptoms, and those with IBS-D often find relief from a dairy-free diet (Holford, 2014).

The NHS also recommends a low FODMAP diet. This is a diet that is low in poorly absorbed fermentable carbohydrates. Many people find a reduction in symptoms by making these dietary changes. More information can be found by clicking here and here.  Bananas are especially good at easing IBS-D as they contain pectin that binds loose stools (Vukovic, 2003).

There are other possible causes for IBS symptoms that you may wish to investigate further, these can include an overgrowth of ‘bad’ bacteria in the gut known as small intestinal bacterial overgrowth (SIBO).  Bacterial imbalances can be addressed by adding more ‘good’ bacteria to your diet via probiotics such as Lactobacillus acidophilus and bifidobacteria.  This is particularly important if your IBS symptoms started after taking a course of antibiotics or is IBS-PI.

Cutting down on the amount of sugar, yeast and alcohol in your diet reduces the chances of causing damage to the gut, an overgrowth of unwanted bacteria, as well as reducing the risk of wider issues such as an overgrowth of candida (a fungus) which is thought to be an underlying problem for some (McIntyre, 2006).  If your IBS is very persistent it may be due to increased gut permeability (leaky gut syndrome) in which case steps to heal the gut should be followed (new blog on healing the gut coming soon!) 

It is thought that people with IBS have highly sensitive digestive nerves and signals such as indigestion which are tolerable to the majority of people are amplified and can cause extreme pain.  Research is being undertaken into the brain-gut axis.  Those with IBS are sadly often prone to episodes of anxiety and depression, thought mainly to be due to the negative impact IBS has on their day to day lives.  Recent research suggest that intestinal flora (bacteria) can have a significant impact on the brain.  A recent study by John Cryan et al found that men taking probiotics for four weeks showed significantly reduced signals of stress and anxiety (Lambert, 2015).

IBS symptoms are often exacerbated by stress and are thought to have an emotional or psychological element. By taking steps to try to reduce your stress levels your IBS could significantly improve. Take gentle walks, try yoga, mindfulness and meditation. A study by Gaylord et al (2011) showed that living mindfully reduced IBS suffers symptoms by a quarter.  Some people, especially those with traumatic past life experiences, find their IBS symptoms improve after a course of specifically tailored hypnosis with a qualified hypnotherapist.

Herbs that can help:

Peppermint (Mentha piperita)
Take as oil capsules or tea. Peppermint can act as an antispasmodic reducing bowel spasms.
German Chamomile (Matricaria recutita)
Take as a tea or tincture.  German Chamomile has nervine properties and acts as an antispasmodic calming spasms in the digestive system and thus decreasing pain and bouts of diarrhoea.
Psyllium Seed (Plantago psyllium)
Ground seeds soaked in water overnight.  These seeds are a good regulator and provide bulking fibres to the stools to reduce diarrhoea as well as aiding movement of the stool along the digestive tract to avoid constipation.
Mashmallow Root Extract (Althaea officinalis)
Take as capsules, or in a powdered form made into a tea. Marshmallow root extract contains mucilage which coats and lines the digestive tract aiding smoother movement of faeces through the intestines. It is also believed to have painkilling properties.
Thyme (Thymus vulgaris)
Prepared as an infusion. Thyme acts as an excellent antispasmodic, soothing the bowel and is particularly useful for IBS-D.
Bilberry (Vaccinum myrtillus)
Prepared as a tea, useful when experiencing diarrhoea.
Meadowsweet (Filipendula ulmaria)
Taken as a tea, meadowsweet soothes the digestive tract and is useful for all digestive conditions.
Valerian (Valeriana officinalis)
Taken as a tincture, valerian reduces stress levels and digestive spasms.  It can be used to ease sleep.
Ginger (Zingiber officinale)
Taken as a tea or just increased in the diet, ginger reduces nausea, acts as an antispasmodic, has anti-inflammatory properties and is a traditional ingredient used to ensure absorption from the digestive system (Bartram, 1998).
A combination of calendula (Calendula officinalis), dandelion (Taraxacum officinalis), fennel (Foeniculum vulgare), lemon balm (Melissa officinalis) and St John’ s Wort (Hypercium perforatum)
A careful mix of these tinctures can relieves both constipation and diarrhoea, act as an antispasmodic and calmative. Especially useful for very persistent chronic IBS.
Thyme-258x300
Thyme: an excellent antispasmodic.

Please bear in mind herbs can have different effects on different people and there is no ‘one-size fits all’ solution.

For further information and consultation tailored specifically to improve your digestive health and well-being, including information on appropriate dosages please contact Rachel Barrow: Medical Herbalist by clicking here.

Caution:

You should go to a medical professional to get IBS diagnosed. Do NOT rely on self-diagnosis.

If you have blood in your stools this is NOT IBS, seek medical advice immediately.

If your blood tests come back indicating there is inflammation in your body, if experience sudden unexplained weight loss, and you have a family history of Coeliac disease or Inflammatory Bowel Diseases (Ulcerative Colitis or Crohn’s Disease) your GP should send you for further testing.

Always consult with a herbalist and a medical professional before beginning any herbal regime. Herbs can interact with current medications and certain herbs should not be used when you have pre-existing health conditions.

References

Balch, P.A. 2012. Prescription for Herbal Healing, 2nd Edition, London: Penguin Books.

Bartram, T. 1998. Bartram’s Encyclopedia of Herbal Medicine, London: Constable and Robinson.

Gaylord, S.A. et al. 2011. Mindfulness training reduces the severity of irritable bowel syndrome in women: Results of a randomised controlled trial. American Journal of Gastroenterology; 106(9): 1678-88.

Holford, P. 2014. Good Medicine, London: Piatkus.

Lambert, C. 2015. Gut Thinking. New Scientist. 21 November 2015.

McIntyre, A. 2006. The Top 100 Herbal Remedies, London: Duncan Baird Publishers.

NHS. 2014. Irritable Bowel Syndrome. [Online]. [Accessed 08 February 2016]. Available from: http://www.nhs.uk/Conditions/Irritable-bowel-syndrome/Pages/Introduction.aspx

Vukovic, L. 2003. 1001 Natural Remedies, London: Doring Kindersley.

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Herbs to Help You Relax

Stress is a reaction to being under too much pressure, where you feel unable to cope (NHS, 2015). There are numerous causes of stress from demands at work, relationship issues, changes in life circumstances (even good changes), financial worries etc. Stress can be short-term (acute) or persist for a long time (chronic). If you feel unable to cope you should contact your GP for advice as soon as possible.

Stress presents itself differently in different people, symptoms include: sleep problems, fatigue, palpitations, irritability, memory problems and lack of concentration, skin problems (e.g. hives, eczema), tension in the body (e.g. neck, shoulders), hair loss and high blood pressure (Glenville, 2010). Long term stress can lead to a plethora of health issues, including anxiety, depression, digestive issues such as IBS, high blood pressure and heart problems…..but let’s try not to get stressed about that!

Here’s what you can do to manage your stress levels:

Basic stress management techniques include mindfulness, exercise such as yoga, breathing exercises, taking some time to yourself to do an activity that you enjoy and eating a healthy diet that is low in caffeine, alcohol and sugar. Continue reading for herbal remedies to help you relax. For more information on basic stress management techniques from the NHS click here and here.

A Limeflower (photo courtesy of www.lemis.com)
A Limeflower. Photo courtesy of http://www.lemis.com.

Herbs to help you relax:

Herbs affect everyone differently, please make sure you read the cautions at the end of the article. If you are unsure of whether these suggestions may be suitable for you and are not sure of the doses please consult a qualified herbalist and/or your GP. If you wish to arrange a consultation with me (Rachel Barrow: Medical Herbalist) please click here.

Valerian Root (Valeriana officinalis)

Valerian is a powerful, non-addictive, herb to be taken in times of extreme stress or anxiety. It can be made as a tea, although there are essential oils that could escape, so ensure that you use an airtight container or lid for the preparation. Most people, however, do not like the taste. Details on how to make your own valerian tincture coming soon! Valerian has been used since Hippocratic times and has since been shown to naturally relax the Central Nervous System (Balch, 1998). It can be taken safely in combination with skullcap, limeflowers, passionflower, hops or oats depending on what would best suit the individual. Caution: valerian can cause headaches and giddiness in some people.

German Chamomile (Matricaria recutita)

German chamomile (which is the type of chamomile in ‘chamomile tea’) is useful for helping you relax during short-term stress. As an adult, you can have a cup of tea as desired. Chamomile is a mild sedative and can calm anxiety, soothe irritability and reduce nightmares (McIntyre, 2006).

add Catnip (Nepeta cataria L.) if you are feeling adventurous.

If you want to make your own tea, add 1tsp of dried chamomile flowers and 1 tsp of catnip to 250ml of water. Seep for 10 minutes and then strain (Vukovic, 2003). Catnip is effective against stress as it is a mild sedative. It can cause drowsiness so should be taken in small doses (Balch, 2012).

Hops (Humulus lupulus) and Passionflower (Passiflora incarnata)

Hops, best known for flavouring and stabilising beer, can be particularly useful in soothing stress related digestive issues due to their antispasmodic, calming effect. Do not take hops if you are suffering from depression. Contrary to popular belief, hops are gluten-free and can be taken by those with coeliac disease (although obviously not when they are in beers containing barley/wheat etc!). They are best taken as a tea, tincture or made into a pillow.

Hops work well when they are taken in combination with another herb. One effective combination for some is with passionflower.

Passionflower is particularly useful for tackling insomnia. It calms the nerves and reduces muscle tension (McIntyre, 2006).

Ginseng:

‘Siberian ginseng’ (Eleutherococcus senticosus)’

Taken as a tincture for improving memory and concentration during times of stress.  Siberian ginseng is traditionally used for stress caused by weather or environmental changes (Balch, 2012). It strengthens the adrenal glands helping the body to cope (Vukovic, 2003). Do not take for more than six weeks. Avoid if you have prostate cancer or any autoimmune disease such as lupus or rheumatoid arthritis.

‘American ginseng’ (Panax quinequefolium)

Taken as a tincture to restore health and for general well-being during chronic stress (Balch, 2012).

and ‘Ginseng’ (Panax ginseng)

Ginseng is a nerve tonic for helping memory and reducing cardiovascular problems during prolonged stress (Balch, 2012).  It is usually taken as a tincture.

Skullcap (Scutellaria lateriflora)

Skullcap limits the production of a particular hormone associated with stress, the adrenocorticotropic hormone (Balch, 2012). It can be taken as a tea and has uplifting properties. Do not take if you have diarrhoea.

Lavender (Lavandula officinalis)

Lavender flowers can be used in teas, but their aromatic essential oils can be used to relax muscles and ease the mind (McIntyre, 2006). Lavender is often used for aromatherapy baths, massage oils or temple balms to induce deep relaxation.

Limeflower (Tilia europaea)

Limeflower tea can reduce stress headaches, lower irritability and lower high blood pressure as well as decreasing the occurrence of palpitations (McIntyre, 2006). Do not use if you have low blood pressure or are taking blood pressure medication.

There are many herbs that have calmative effects and just a few are covered here. If you would like to research further you may wish to consider:

Vervain (Verbena officinalis)

Lemon Balm (Melissa officinalis)

Oats (Avena sativa)

Picture courtesy of Lissalaine Photography.
Picture courtesy of Lissalaine Photography.

Caution:

  • If you have thoughts of self-harm or suicide, contact a medical professional immediately.
  • You should check with your GP before commencing any herbal regime especially if you take medication, have long-term health issues, are pregnant, breastfeeding or elderly. Although herbs are generally considered safe, they can have contra-indications and react with other medications that you are taking. If you have any side effects discontinue use and contact a medical professional immediately.
  • Do not self-diagnose, if you are experiencing symptoms that you think are related to stress such as headaches and palpitations, check with you GP that they are not due to any other underlying health issues.

References

Balch, P.A. 2012. Prescription for Herbal Healing, 2nd Edition, London: Penguin Books.

Bartram, T. 1998. Bartram’s Encyclopedia of Herbal Medicine, London: Constable and Robinson.

Glenville, M. 2010. The Natural Health Bible for Women, London: Duncan Baird Publishers.

McIntyre, A. 2006. The Top 100 Herbal Remedies, London: Duncan Baird Publishers.

NHS. 2015. Struggling with stress? [Online]. [Accessed 02 November 2015]. Available from: http://www.nhs.uk/Conditions/stress-anxiety-depression/Pages/understanding-stress.aspx

Vukovic, L. 2003, 1001 Natural Remedies, London: Doring Kindersley.

Herbs to alleviate PMS

Premenstrual syndrome (PMS), also known as premenstrual tension (PMT), refers to the vast range of symptoms that can occur within the last two weeks of a woman’s menstrual cycle (where day one is the first day of menstruation). These symptoms can be physical, behavioural or psychological (NHS, 2015a). It is now thought there may be 150 different symptoms associated with PMS, and nine out of ten women who menstruate experience more than one symptom per month (Glenville, 2010). Symptoms can vary between individuals, and can differ for an individual on a monthly basis.

Some of the most common symptoms include:

  • headaches,
  • feeling bloated,
  • tender, swollen or sore breasts,
  • muscle or joint pain,
  • insomnia,
  • anxiety,
  • mood swings,
  • feeling upset or emotional,
  • food cravings and appetite changes,
  • spots,
  • abdominal cramps.

Not all symptoms associated with PMS are negative, some women feel an increase in clarity or productivity prior to their period.

If your PMS symptoms stop you from being able to undertake your usual daily activities you should consult your GP as you may be experiencing premenstrual dysphoric disorder (PMDD). Typical symptoms include a sense of hopelessness, depression, extreme tension or irritability and very low self-esteem (NHS, 2015b).

What causes PMS?

There is thought to be a combination of factors that lead to PMS being more problematic for some women than others. Poor diet, lack of exercise and high levels of stress are the main contributors. There also appears to be a genetic element (Glenville, 2010). PMS can affect menstruating women of any age, although statistically, those in their late twenties and early forties appear to experience an increase in symptoms (NHS, 2015a). Women who have recently given birth or have had a miscarriage or termination may also be more likely to suffer with PMS (Glenville, 2010).

A woman’s hormone levels change throughout her menstrual cycle. After ovulation, which occurs approximately 14-16 days prior to the start of the next period, the ‘luteal phase’ is entered. The corpus luteum (egg-sac) produces progesterone, causing the uterus lining to thicken so it is prepared for a fertilised egg to implant. If an egg is not fertilised then oestrogen and progesterone levels drop and you begin a new cycle. PMS is thought to be associated with hormonal imbalances of oestrogen and progesterone (Bartram, 1998).

If you have a healthy diet that includes plenty of fruit and vegetables, a low intake of salt, alcohol and caffeine; exercise regularly and take measures to try to reduce your stress levels and yet still experience PMS, you may wish to consider the use of herbs to support your general well-being and try to alleviate your symptoms.

A rose in the Botanical Gardens, Sheffield, United Kingdom.

Herbs to alleviate PMS

There are may herbs associated with alleviating the symptoms of PMS. I have selected five to consider here:

Chamomile (Matricaria recutita)

Typically taken in tea form, chamomile is a relaxant that soothes irritability and reduces anxiety. Its painkilling properties can help to relieve headaches, and bloating can be reduced due to its diuretic effect. It can regulate the digestive tract to alleviate both diarrhoea and constipation (McIntyre, 2006). It can be used in conjunction with dandelion root if constipation is an issue. Click here for more information about dandelions. Chamomile can also relieve muscle pain (Balch, 2012).

Vervain (Verbena officinalis)

Typically taken as a tincture or a tea, vervain has relaxing and up-lifting properties. It is a bitter herb that stimulates the liver and digestive system, which can assist in hormone regulation (McIntyre, 2006).

Black cohosh (Cimicifuga racemosa)

Typically taken as capsules or in a tincture form, black cohosh contains phytoestrogens which can offset the decline of oestrogen should this be problematic. Black cohosh can relieve depression and muscle pain (Balch, 2012). It calms the nervous system and can balance hormones. It may reduce anxiety and premenstrual headaches (Glenville, 2010). NOT to be taken if you have a chronic disease or liver problems.

Rose flowers (Rosa Gallica L. Rosa Damascena Mill. Rosa centifolia)

Typically taken in tincture or tea form, rose is traditionally used to ‘lift the spirits’. It is a mild sedative, liver protector and menstrual regulator (Bartram, 1998). It can induce a restful sleep. Rose water applied to the skin can help combat acne (McIntyre, 2006).

Raspberry leaf (Rubus idaeus L.)

Typically taken as a tea, raspberry leaves contain tannins and flavonoids that can relieve premenstrual cramps (Balch, 2012). It is widely recognised that raspberry leaves tone the muscles supporting the uterus, and they are traditionally used to ease childbirth and relieve menstrual pains (Bartram, 1998).

Caution:

  • If you are unsure whether you are experiencing symptoms of PMS please consult a doctor. There can be many causes for abdominal pain, breast pain and headaches etc that may need addressing further. Do not self-diagnose any medical condition.
  • You should talk to a qualified herbalist and medical professional before beginning any herbal regimes. Although herbs are generally considered safe, they can have contra-indications and react with other medications that you are taking. If you have any side effects discontinue use and contact a medical professional immediately.
  • Some herbs alter your hormone levels and may reduce the effectiveness of hormonal contraceptives or replacement therapies (e.g. contraceptive pill).
  • If you are currently trying to conceive, herbal remedies should not be taken unless under the guidance of a qualified herbalist.
  • Although widely used, I have NOT suggested the use of agnus castus (Vitex agnus castus), which may also be sold as chasteberries, for alleviating PMS. It can cause the release of several eggs from the ovaries, resulting in multiple births and should be avoided unless being used under direction of a qualified herbalist addressing fertility issues.
References:
Balch, P.A. 2012. Prescription for Herbal Healing, 2nd Edition, London: Penguin Books.
Bartram, T. 1998. Bartram’s Encyclopedia of Herbal Medicine, London: Constable and Robinson.
Glenville, M. 2010. The Natural Health Bible for Women, London: Duncan Baird Publishers.
McIntyre, A. 2006. The Top 100 Herbal Remedies, London: Duncan Baird Publishers.
NHS. 2015a. Premenstrual Syndrome (PMS). [Online]. [Accessed 20 October 2015]. Available from: http://www.nhs.uk/Conditions/Premenstrual-syndrome/Pages/Introduction.aspx
NHS. 2015b. Symptoms of premenstrual syndrome (PMS). [Online]. [Accessed 20 October 2015].  Available from: http://www.nhs.uk/Conditions/Premenstrual-syndrome/Pages/Symptoms.aspx