Irritable bowel syndrome.

The irritable bowel syndrome (IBS) is a condition in which the large intestine, or colon, fails to function properly. It is also known as nervous indigestion, spastic colon, mucus colitis and intestinal neurosis.

The causes of IBS are not entirely clear. There is no evidence that any structural defects of the bowl are associated with IBS, but a variety of physiological, psychological and dietary factors have been identified as possible causes. 

IBS has characteristic symptoms which can include a combination of any of the following: abdominal pain and distension; more frequent bowl movements with pain, or relief of pain with bowel movements; constipation; diarrhoea; excessive production of mucus in the colon; symptoms of indigestion such as flatulence, nausea and varying degrees of anxiety or depression.

Non-Gastrointestinal features of IBS are, gynaecological symptoms (premenstrual tension, dysmenorrhoea and dyspareunia), urinary symptoms (frequency, urgency, nocturia and incomplete emptying of the bladder), back pain, headaches, fatigue, poor sleeping, etc.

Conditions which may mimic IBS.

Miscellaneous dietary factors such as excessive consumption of tea, coffee, carbonated beverages and simple sugars. Infectious enteritis such as amoebiasis and giardiasis.

Inflammatory bowel disease (Crohn’s disease and ulcerative colitis). Lactose intolerance. Laxative abuse. Intestinal Candidiasis.

Disturbed bacterial micro flora as a result of antibiotic or antacid use. Malabsorption diseases such as pancreatic insufficiency and coeliac disease.

Metabolic disorders such as adrenal insufficiency, diabetes mellitus and hyperthyroidism. Mechanical causes such as faecal impaction.        

Diverticular disease. Cancer. Therapy. Increasing dietary fibre. The fibre from wheat bran should be avoided in people with IBS as wheat is among the most commonly implicated foods in malabsorptive and allergic conditions. Individuals will respond better to fibre from sources other than cereals, particularly water-soluble fibre like that found in vegetables, fruits, oat bran, guar, Psyllium and legumes (beans, peas, etc.). Food sensitivity. According to double-blind challenge methods, the majority of patients with IBS have at least one food intolerance and some have multiple intolerances.

Since in most cases the reaction appears not to be mediated by the immune system ,and hence, the elimination/challenge method is the least expensive food sensitivity detector and appears to yield the best results in patients with IBS.

A large number of patients feel a marked improvement when following the oligoantigenic diet. It is interesting to note that many IBS patients have other symptoms suggestive of food allergy such as heart palpitation, hyperventilation, fatigue excessive sweating headaches etc. Candidiasis. Overgrowth of Candida albicans in the digestive tract favours the development of allergic and pseudo-allergic reactions, and this makes it a complicating factor in IBS. It would be advisable to bring it under control.

Psychological factors. Almost all patients with IBS complain of mental/emotional problems such as anxiety, fatigue hostile feelings, depression and sleep disturbances. Psychotherapy in the form of biofeedback or short term counselling has sometimes proved successful.

An increase in physical exercise appears helpful for IBS patients suffering from stress. Many people find that daily leisurely walks markedly reduced symptoms Probiotics, Botanical medicines and herbal antispasmodics. 

There have been excellent results obtained from the use of alternative medicines, probiotics, botanical medicines and herbal antispasmodics. these however should be prescribed by a registered naturopath and not just purchased over the counter. Since the diagnosis of IBS is typically made by exclusion, a careful diagnosis is always required.