Autonopedia

IRRITABLE BOWEL SYNDROME

SECOND ONLY TO BAD COLDS, irritable bowel syndrome (IBS) is a common reason that people miss work. It is also one of the primary reasons that people go to the doctor.
A syndrome is a group of characteristic symptoms, not a disease. The usual symptoms that comprise IBS - constipation or diarrhoea, along with severe bloating and wind - can be caused by a variety of ailments or conditions. Be sure of your diagnosis before you begin exploring your treatment options.

Conventional drug treatments for IBS include laxatives, antispasmodics and tranquillisers. In the past, when these didn't help, doctors often attributed a patient's symptoms to psychological factors. Although stress can certainly play a role in most digestive disorders, it's unlikely to be the sole cause of the problem. Today when you see a doctor, you'll find him or her more willing to look for abnormalities such as food allergies or intolerances, and for digestive problems caused by insufficient pancreatic enzyme or stomach acid production. It's also worth looking into your digestive system's ecology. Parasites from tainted food and water can cause the same symptoms as irritable bowel syndrome; antibiotic use can lead to the overgrowth of yeasts and other unhealthy bacteria. These microscopic organisms produce toxins that irritate the bowel wall, making it more sensitive and disrupting peristalsis, the normal flow of food through the digestive system.

IS IT ALLERGY RELATED'
One source estimates that up to two-thirds of people with irritable bowel syndrome have one or more food allergies. Determining which foods cause allergies can be difficult and time-consuming. The most common offenders include dairy products and gluten-rich grains such as wheat; however, your own irritable bowel symptoms might be a reaction to almost anything. One of the easiest ways to help pinpoint your own possible culprits is to keep a detailed food diary, recording foods eaten and symptoms. If you notice that certain foods consistently make you feel bad, try eliminating them from your diet - one at a time - and see if your symptoms improve.

DRUG TREATMENT

Antispasmodics
Atropine, atropine compounds (Actonorm Powder, APP), dicyclomine (Merbentyl), hyoscine butylbromide (Buscopan), propantheline bromide (Pro-Banthine). Function: relax the bowel wall and ease cramps. Side effects: dry mouth, difficulty urinating, constipation, dizziness, blurry vision, nervousness, insomnia.

Antidiarrhoeal Agents
Loperamide (Imodium), co-phenotrope (Lomotil). Function: affect the bowel wall to stop erratic or excessive digestive contractions. Side effects: allergic reactions, abdominal distension, constipation, drowsiness, dry mouth, nausea, vomiting.

Laxatives
Lactulose (Osmolax, others), magnesium citrate, macrogols (Movicol), bisacodyl (Dulco-lax), magnesium hydroxide, others. Function: activate muscles in the bowel wall to induce bowel movements. Side effects: diarrhoea, bloating (from lactulose), cramping, dependence on laxative for proper bowel function.

Surfactants
Activated dimeticone. Function: theoretically to reduce and disperse trapped wind bubbles, but may not be effective. Side effects: unknown.

TIPS FOR A HEALTHY BOWEL
Just as a garden needs constant weeding and pruning, your intestines need regular attention and maintenance. This is especially true for people with irritable bowel syndrome. Part of that maintenance involves good eating habits, including the following strategies.
Take it easy.Try to make mealtime as calm and stress-free as possible. Eating more slowly and taking time to chew food thoroughly is a great way to improve digestion.
Find the fibre. Get enough of this key component from fruits, vegetables and some grains. Fibre can help both constipation and diarrhoea by regulating peristalsis, the involuntary muscle contractions that move food.
Pass up the wind causers. Avoid wind-forming foods such as beans, cabbage and carbonated beverages. If you can't avoid them entirely, consume these foods in small quantities only.
Trim the sugar. Because carbohydrates can ferment in the intestines and produce wind, many people find that cutting out refined sugars, or even all carbohydrates, can reduce or even eliminate symptoms.
Accept no substitutes. Be aware that sorbitol and xylitol - indigestible carbohydrates used as artificial sweeteners - can aggravate irritable bowel symptoms.
Avoid irritants. Fatty foods and coffee, regular or decaffeinated, can induce intestinal spasms, resulting in cramps or diarrhoea. Try alternatives to your usual coffee and drive past the fast-food outlets.

BOWEL-BOOSTING SUPPLEMENTS
One of the single most helpful supplements for irritable bowel syndrome is Lactobacillus acidophilus. This beneficial bacterium has been shown to suppress the overgrowth of unhealthy bacteria, yeasts and parasites. L. acidophilus is commercially available as a powder or capsule. For best results, obtain a product that guarantees at least 2.5 billion live organisms per gram and take 1,000 to 4,000 milligrams per day.

Another very useful supplement is digestive enzymes, which assist in the thorough breakdown of foods. Several sources are available, including pancreatic extracts (from cows), papain (from papaya), bromelain (from pineapple stem) and cultured moulds (such as Aspergillus species). The typical dosage is one to four capsules taken with meals, although dosage varies from one product to another. Follow the manufacturer's directions. All of these enzymes are safe to use for extended periods of time.

In Asia rice-bran oil is used extensively for cooking and salad dressing but is also recognised for its medicinal properties. Doctors in Japan use it as a treatment for numerous medical conditions, including irritable bowel syndrome and gastritis. It is rich in a substance called gamma-oryzanol, which has been shown to normalise acid production in the stomach and to decrease inflammation of the intestinal lining, thus soothing the entire intestinal tract. Rice-bran oil is available in gourmet and health food stores; it is also available as a dietary supplement. The typical dosage is 1 to 2 table­spoons of oil per day, mixed into foods; or one 100- to 200-milligram capsule of gamma-oryzanol three times per day with food.

HERBAL REMEDIES

Peppermint (Mentha x piperita)
Pain-relieving, anti-inflammatory and antimicrobial, peppermint has a long history of use for intestinal problems including indigestion, cramping and bloating. It also fights yeast organisms. Mints are members of the group of herbs called carminatives, which relax the muscles of the lower oesophagus and allow the release of wind trapped in the stomach.

Although mint tea is useful for stomach upsets, peppermint essential oil is better for IBS. Several studies have confirmed that this oil acts directly on the smooth muscles lining the intestinal walls to decrease erratic contractions and alleviate spasms. For peppermint oil to reach the colon, however, it must be taken as an enteric-coated capsule, which shields the oil from the digestive enzymes of the stomach. Typical dosage: 1 to 2 capsules containing 0.2 millilitre of the oil two or three times per day as needed; or dilute a few drops of the oil in 2 tablespoons of vegetable oil and rub directly on the site of discomfort such as the lower abdomen. Caution: do not use peppermint internally if you have heartburn or oesophageal reflux.

Psyllium (Plantago ovata)
The seed husks from this plant have a long history of use by herbalists and medical doctors alike for the treatment of constipation and recurrent diarrhoea. Psyllium is rich in fibres similar to those found in oat bran, flaxseed meal and guar gum. These fibres form a soft bulky material that gently regulates peristalsis. Typical dosage: up to 1 tablespoon of seed husks or 2 teaspoons of powdered seed stiffed into 1/4 litre of water, once per day (drink 30 minutes to 1 hour after eating or taking other drugs). Don't let the mixture set once mixed; the blend thickens quickly and becomes difficult to drink.

Camomile (Matricaria recutita)
This popular, versatile herb acts as a sedative, relieves wind, calms intestinal spasms and fights inflammation. It soothes the gastrointestinal tract and helps fight both constipation and diarrhoea. Typical dosage: 3 to 4 cups of tea per day (steep 1/2 to 1 teaspoon of dried flowers in 1/4 litre of hot water for 10 minutes); or 10 to 40 drops of tincture three times per day; or up to six 300 or 400 milligram capsules per day in divided doses - all taken between meals. Caution: avoid if you have heartburn or are allergic to other plants in the aster family, which includes ragweed.