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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