I see many patients each week who have been diagnosed with irritable bowel syndrome (IBS). The good news is that I often find that with some good questioning and an individualised treatment plan covering the multiple aspects of this condition, a patient’s abdominal pain and bowel habits often respond for the better.
IBS is the most common digestive condition that patients seek help for and, believe it or not, accounts for up to a third of visits to gastroenterologists.
IBS is diagnosed by eliminating other disorders through medical testing. An IBS diagnosis is made when a patient has recurrent abdominal pain or discomfort for at least three days of the last three months and at least two symptoms from the following:
- Improvement of pain with bowel movement
- Onset associated with a change in the stool frequency
- Onset associated with a change in the stool consistency
The causes of IBS are poorly understood and so this means that conventional treatment is targeted towards reducing the symptoms. Interestingly, it is antidepressant medications that seem to offer the most relief to IBS patients from the pharmaceutical model. Additionally, antispasmodics and anti-diarrhoeal medications are often trialed.
There are many natural therapies that have been used traditionally for digestive conditions and some of these treatments have shown statistically significant results in clinical trials.
- Herbal medicine and nutrition therapy do have plenty to offer a patient with IBS and this is backed by clinical trials. One of the most effective herbal remedies tested in double blind clinical trials is a herbal formula known as Iberogast. A study found that Iberogast significantly reduces abdominal pain and other IBS symptoms. I use a lot of Iberogast with my IBS patients when I feel that the formula fits their pattern and it usually brings excellent results.
- Probiotics have also been the subject of several clinical trials and there is good evidence for their use in IBS. They are particularly useful in patients who suffer from bloating, flatulence and abdominal pain. Probiotics enhance the gut barrier function and inhibit pathogen binding. Many probiotic strands are available, so you need to work with a practitioner to get the correct strands and dosing. In addition to supplementing with probiotics, increasing probiotic rich foods (such as yoghurt, keffir, miso, tempeh and sauerkraut) may be beneficial.
- Fibre, particularly soluble fibre such as psyllium husks, is also supported by research for use in IBS, particularly where constipation is a predominant factor. Soluble fibres should be taken before meals for a greater impact on the lower digestive system.
- Dietary causes play a part in IBS. It is worth having your diet assessed by your practitioner to identify if there are any foods that are aggravating your system. I often refer patients for food sensitivity testing which takes some of the guess work out of finding out which foods aggravate your symptoms and diets based on this testing have significantly reduce symptoms in clinical trials. Not all patients need to follow a dairy and gluten free diet – however this does work well for some – testing helps us to identify which foods are causing your problems.
- One of the most important factors in treating IBS is managing stress and anxiety. Seek assistance in resolving ongoing life stresses or anxieties. Hypnosis is well supported in research for managing IBS. Additionally, choose counselling, meditation, yoga, massage and relaxation techniques to help you feel more relaxed. Acupuncture is excellent for enhancing relaxation and has been used for thousands of years for alleviating digestive pain and bowel disorders too.
Traditional Chinese Medicine has several diagnostic patterns for IBS. One of the most common is known as “Liver invading the Spleen”. Basically, this means that when feeling emotions such as frustration, resentment, irritability and anger your digestion system is weakened and your symptoms are worse. If you have this pattern you may suffer from alternating constipation and diarrhoea, and it is hard to pinpoint any foods that make your condition worse. (Here’s a little more on Liver Qi Stagnation, the precursor to Liver invading the Spleen.) It is no surprise then that it is the antidepressant medications that have shown the greatest improvement in this condition from a pharmaceutical point of view. There are many drug-free stress reduction options, and these are listed in the last bullet point above. This brain-gut connection highlights the importance of an holistic strategy in the management of IBS.
To book an appointment at the clinic or further information on Chinese Medicine contact Dr Sarah George (Acupuncture). Sarah is a practitioner of acupuncture (AHPRA registered), massage therapy and natural health.