Irritable bowel syndrome (IBS) is a common gastrointestinal condition that is characterized by altered bowel habits with specific symptoms of diarrhea, bloating, constipation, flatulence, abdominal distress, and urgency to defecate.
These symptoms appear even though when the bowel and digestive tract are probed, scoped, and/or X-rayed, nothing appears abnormal about the structure of the gut. Gut problems are one of the most common healthcare challenges and patient’s symptoms can be sporadically severe or experienced on a daily basis. Therefore, assessment and proper support for GI function is crucial in promoting health and healing from many diverse complaints.
The intestinal cells are very nutritionally demanding, and the lack of nutrients can result in leaky gut. Essential fatty acids, amino acids (L-glutamine), vitamins (especially B vitamins), antioxidants and micronutrients (zinc) are all important factors in maintaining the integrity of the intestine’s leak-proof lining.
Gastrointestinal Complaints: Abdominal pain, bloating, constipation, diarrhea, gas, indigestion, heartburn, pain in the right and/or left side (pain may be transient and is typically increased with food and reduced by defecation), constipation or diarrhea (some patients will have predominant diarrhea, especially in the morning. Some will have predominant constipation, and others alternate between the two), distention are common, rumbling bowel sounds, nausea, weight loss, and lack of energy.
Neurological Complaints: Aggressive behavior, anxiety, confusion, foggy thinking, poor memory, mood swings, and nervousness.
Breathing Problems: Shortness of breath, allergies and asthma symptoms.
Other Symptoms: Low immunity, recurrent bladder infections, bed-wetting, skin rashes, joint and muscle pain, and chronic fatigue.
IBS can be induced and/or caused by a number of contributing factors, including:
- Infection – One in five patients with IBS is able to trace their onset of illness to a gastrointestinal infection. Antibiotics may be needed, but they can further contribute to diarrhea. Always take probiotic support when on antibiotic therapy, for the 10-14 days on the antibiotics, and for at least 2 weeks after the antibiotic is discontinued.
- Food Intolerances – The intestinal tract is particularly sensitive to irritation and food allergies or intolerances. Limiting foods that are known to irritate the sensitive lining of the intestine (dairy products, caffeine, alcohol, white flour, refined sugar) may be beneficial.
- Psychological Factors – Stress, anxiety and adrenal overload can have a big impact on the digestive tract leading to diarrhea and/or constipation. Finding a way to calm the mind can also calm the gastrointestinal tract.
- Low Fiber Intake – Ongoing constipation is a problem in some IBS cases. Eating more plant-based foods (especially green and yellow vegetables) and consuming more filtered water can help.
- Overuse of Antibiotics – Can lead to irregular bowel flora leading to internal yeast (Candida albicans). Probiotic support will help alleviate this problem.
- Other Factors – IBS can be induced by chemotherapy, radiation, NSAID drugs like (Motrin, Advil and ibuprofen), steroid drugs (like prednisone, cortisone), parasites (giardiasis), acute poisoning, and malnutrition.
- Other Diseases – Crohn’s disease, acne rosacea, alcoholism, childhood ear infections, ulcerative colitis, celiac disease, inflammatory joint disease, diverticulitis, eczema, fibromyalgia, migraine headaches, peptic ulcer disease, pancreatic insufficiency, pernicious anemia, HIV, hemorrhoids, psoriasis, and urticaria.
A healthy, physiological intestinal flora is very important for a healthy organism. An unhealthy digestive system function causes diarrhea, constipation, bloating, belching, rebound acidity or flatulence. Dysbiosis of the small intestines may be caused by surgical trauma, environmental and emotional stress, and altered intestinal transit. Which can facilitate the overgrowth of bacteria and contribute to malnutrition. The germs form toxins, which may affect the liver, interstitial connective tissue and the immune system and cause an overgrowth of candida/yeast. The first thing to attempt to do is correct the pH and digestive problems.
Dietary influences are significant on bowel flora. People who eat a Western diet consisting of too much meat and protein have many more gram negative, non-spore forming anaerobes in their feces. High animal protein may mutate the bowel bacteria, thus increasing procarcinogenic activity. This has been linked to an increase in colon cancer. People who ate a more Eastern vegetarian diet were found to have higher proportion of aerobe (oxygen breathing) bacteria, and an increase in Lactobacillus.
Anxiety, stress, and depression also changes the microflora. Anxiety is associated with increased bowel frequency, and depressed patients tend to be constipated. The composition of the flora is very sensitive to changes in the host’s intestinal tract. Emotional reactions trigger changes in intestinal motility and enzyme, bile, and/or mucin secretion. Mucin is an important substrate for many intestinal microorganisms. The link between disturbed bowel function and psychological factors is strengthened by studies done on hospitalized patients with IBS.
Microbial ecology balance is a major concern for any with bowel disease or problems. The threat to normal bowel ecology may result in dysbiosis. The human body maintains a rich and diverse microbial flora. Virtually every surface of the body having contact with the outside world has been colonized by various bacteria and fungi. Normal flora implies that microbes live with us in balance and cause no harm.
Food sensitivities can be a problem. Identify food allergies, aggravating foods, desensitize and utilize the Elimination Diet. It is vital to improve nutrition and avoid excessive fat intake. Other dietary recommendations for Leaky Gut Syndrome include:
- Eat foods that have natural antimicrobial properties such as onions, radishes, ginger root, lemon juice, tumeric, mustard, and rosemary.
- Eat cruciferous vegetables that have detoxifying properties such as cabbage, cauliflower, Brussels sprouts, and broccoli.
- Eat more foods high in omega-3 essential fatty acids such as cold-water fish, flax meal and flaxseed oil, avocados, and walnuts.
- Drink spring water throughout the day.
- Eat more complex carbohydrates that are digested slowly and gradual increase blood glucose levels (without stressing the pancreas), such as pumpkin, sweet potatoes, and apples.
- Consume more nutritious fiber foods fruit, any green or yellow vegetable (but limit potatoes, tomato, eggplant, pepper and corn), fruits, olive oil, spring water, lemon or lime juice, and herbal teas.
- Avoid or eat very sparingly all “white” foods that can be irritating and a potential problem for IBS sufferers. They include white sugar (30% of cases consume excess) and refined carbohydrates, most or all dairy products (yogurt and butter may be OK) and white flour products (donuts, pastries, cookies, cakes, crackers, white bread).
- Limit intake of pickled foods such as pickled cucumbers, mushrooms, relishes and sauerkraut.
- Avoid fermented cheese and wine.
- Avoid all foods containing refined sugar or artificial non-nutritional sweeteners such as aspartame (Equal), Splenda, MSG,saccharine, and all artificial colorings.
- Avoid allergenic foods (for some people) such as casein in dairy products, gluten in wheat breads, soy products, and peanuts.
- Avoid excessive alcoholic beverages that hinder functioning of the immune and digestive systems and retard the healing process.
- Avoid drinking carbonated beverages and chewing gum can increase problems with gas in the intestines.
- Avoid junk foods and fast foods which are loaded with chemicals that cause direct irritation of the intestinal lining. Commercial deep-frying often relies on hydrogenated vegetable oils that are loaded with noxious trans-fatty acids.
- Limit the use of antacids, broad spectrum antibiotics whenever possible, and non-steroidal anti-inflammatory drugs (Advil, ibuprofen, Celebrex).
- Since candida (yeast) can be a common problem, an anti-candida diet may be helpful for patients to regulate their bowel flora.
Other tips to help heal the gut:
- Drink plenty of purified water in between meals.
- Try and juice your fruits and vegetables together for easier digestion.
- Chew your food slowly and thoroughly for proper digestion.
- Eat smaller meals more often, rather than 3 large ones. Perhaps consume a protein shake for a meal replacement.
- Exercise moderately to help sweat toxins out of your body.
Risks And Factors
IBS may be associated with a complementary disease; i.e. fibromyalgia, Crohn’s, colitis. Lesions may form in colon. Stress, drug use, certain foods, antibiotics may induce symptoms. The herb pycnogenol, from the French Pine-bark, may irritate the bowel. Drugs, such as non-steroidal anti-inflammatory (NSAIDS), antibiotics, corticosteroids, excessive alcohol consumption, fasting, excessive stress, nutrient deficiencies, excessive sugar consumption, gastrointestinal infections, cancer radiation therapy, and food allergies are often associated with leaky gut syndrome.
Candidiasis is a common finding with IBS patients, so an anti-candida diet may be helpful to replenish bowel flora.
Exercise is a potential gold mine to improving IBS. Walking, swimming and biking are wonderfully beneficial to toning abdominal muscles and providing stimulus to gently move things along.
A prudent clinical choice to repair gut restoration and chronic disease is to remove, replace, reinoculate and regenerate (see below.)
Additional consumption of fiber has both a healing and a cleansing effect. Good sources of bulk fiber include: oat bran, flaxseeds, psyllium, vegetables, whole-grain breads (avoid wheat bran), potatoes, rice, squash, baked fish and cereals. High fiber diets can quiet the intestinal tract and bulk up the stool. Dosage: 20-30 grams daily. The herbs FLAX SEED and SLIPPERY ELM are fiberous and may relieve constipation.
- PROBIOTIC SUPPORT (ACIDOPHILUS/LACTOBACILLUS)
These are the friendly bacteria residing in the bowel that can add to bowel microflora integrity. It is essential to “reinoculate” the desirable bacteria. Recent medical studies prove that supplementing with probiotics (eespecially Lactobacillus acidophilus and Bifidobacterium infantis) significantly improved quality-of-life symptom scores for IBS patients. Dosage: Take 2-3 doses of either capsules or powder 2-3 times a day between meals
- OMEGA 3 FATTY ACIDS
Omega-3 fatty acid can decrease intestinal inflammation and helpful to protect the intestinal lining. Dosage: As directed on label, approximately 1,000-6,000 mg daily. Consume the grounded form of flax seed, liquid flaxseed oil or oral supplement 3-6 times a day.
Glutamine is an amino acid that is anti-inflammatory and essential for growth and regeneration of cells lining the intestines. L-glutamine also acts as a major metabolic fuel for the intestinal cells. Dosage: 500 mg twice a day on an empty stomach. Take with 50mg of vitamin B6 for better absorption.
- B-COMPLEX VITAMINS
B vitamins are water-soluble vitamins that can aid in the rejuvenation of healthy cells in the gut, and are needed for proper muscle tone in the GI tract. Vitamin B12 is needed for the proper absorption of foods, protein synthesis and metabolism of carbohydrates. Dosage: 1,000-2,000 mcg daily. B-complex dosage: 50-100 mg of each major B vitamin.
In addition to re-inoculating the bowel by introducing bacteria, it is also necessary to bolster the healthy microflora with prebiotics which selectively promote beneficial flora without supporting pathogenic bacterial growth. Prebiotics include inulin, fructans, some soy fibers, and fructooligosaccharides (FOS). FOS added to the diet acts as a food source to nourish certain healthy bacteria.
- DIGESTIVE ENZYMES
Enzymes aid in protein digestion needed to replace factors that may be lacking or lost after “leaky” gut syndrome. Also aid in decreasing inflammation. Dosage: Take one or 2 capsules 5-15 minutes before eating larger meals.
- ALOE VERA JUICE
The juice concentrate promotes a healing and restorative effect on the digestive tract, and may soothe the mucous membranes of the entire intestines. Dosage: 1-4 tbsp. daily.
These smooth and nourish the mucous membranes lining the digestive system and reduce cramping. The Most common demulcent herbs are LICORICE, MARSHMALLOW, PLANTAIN, and SLIPPERY ELM. Dosage: As instructed.
Minerals can relax the muscles in irritable bowel disorders and helps a “nervous stomach” and the central nervous system. Dosage: Calcium 1,000-2,000 mg daily; Magnesium 500-1,000 mg daily.
- MILD LAXATIVES
In some cases of continuing constipation a natural laxative (Senna) or milk of magnesia may be utilized. Dosage: As directed on package.
- BETAINE HCl
A plant-based hydrochloric acid that helps to improves protein digestion and mineral absorption by increasing stomach acid. Betaine may help fight acid reflux and kill bad bacteria in the intestinal tract. Dosage: 300-600 mg with each meal.
A major constituent of the intestinal lining and a barrier layer that helps to protect the intestinal lining form digestive enzymes. This nutrient may also help to promote the growth of beneficial bacteria, inhibits Candida albicans and e-coli, and is needed for intestinal mucous production. Dosage: 250mg twice a day.
- ANTIOXIDANT THERAPY
Antioxidants such as BETA CAROTENE, QUERCETIN, and VITAMIN C and VITAMIN E may help control the allergic response to foods. Dosage: As directed.
- WHEY PROTEIN
A daily powdered nutrient source used for the removal of toxins or allergens from gut. Dosage: As directed on package.
Protocol to Remove, Replace, Reinoculate and Regenerate
Remove – refers to the elimination of any factors that may be causing or exacerbating a dysfunctional GI. These factors include pathogenic microflora (e.g. bacteria, fungi, parasites), food that is allergic, toxic, or intolerant, environmental stressors such as pollution and chemicals, and anxiety or stress. Clinical approach: Elimination diet, bactericidal phytonutrients (green foods), antibiotics, whey globulin complex.
Replace – refers to the replacement of factors that may be lacking or inadequate. Clinical Approach: digestive enzymes, mucosal secretion protectants (e.g. phosphatidylcholine and plantain), nutrients such as zinc and vitamin C, and fiber to support transit and general GI function.
Reinoculate – refers to reintroduction of desirable GI microflora, or “friendly bacteria” called probiotics to balance microflora, as well as support for these probiotics with prebiotic fiber. Clinical Approach: bifidobacteria, lactobacillus, inulin or FOS, soy fiber, soluble rice fibers, and arabinogalactans.
Regenerate – refers to providing nutritional support for healing, growth and regeneration of GI mucosa. Clinical Approach: glutamine, arginine, vitamins A and D, antioxidants, adequate nutrition, nutritional anti-inflammatories (e.g. curcumin, DHA, EPA), and mucosal lining support (e.g. plantain, PC).
Aberdour, S. Irritable Bowel- Irritable Person, Alive#244, December 2003. Pp 44-47.
Balch, JF, Balch PA. Prescription for Nutritional Healing- 3rd edition. Penguin Putman Inc. New York, NY. 2000.
Brown, DJ. Treatment of Pediatric IBS with Peppermint Oil. Herbalgram, Number 52, 2001. P. 22.
Cantanzaro, JA, Green, L. Microbial Ecology and Dysbiosis in Human Medicine. Alternative Medicine Review, May 1997. 2(3): 202-209.
Dawson, L. Patch Up Your Leaky Gut. Alive Magazine #217. November 2000. Pp. 34-35.
Intestinal Health. Advanced Nutrition Publications, Inc. 1995. Metagenic Laboratories.
Kingston, RL. Probiotics: Useful of IBS, Allergic Diseases. Drug Info Line (AphA), June 2003. 8.
Leaky Gut Syndrome. Jigsawhealth.com
Leyton, E. Herbs and Exercise Ease IBS. Alive #224, June 2001. P. 14.
Liska, DJ, Lukaczer, D. Gut Restoration and Chronic Disease. JANA, Fall 2002. 5(4): 20-32.
Lyon, MR. Your Gut May Be Leaking. Alive #231, January 2002. Pp. 46-47.
Michocki, M. Treatment Innovations for Irritable Bowel Syndrome. APhA SpecialReport. 2000.
Miller, MJS, The Impact of Nutritional, Bacterial and Botanical Approaches to GI Dysfunction, JANA, Fall 2002. 5(4): 2-5.
Ryan, L. IBS and IBD- Intestinal problems At A Glance- Part 1. HerbEgram, 2002. MediHerb Co.
Yanor-McRae, R. Calm Your irritable Bowel. Alive #218. Dec. 2000. Pp. 36-37.