It’s that time of year again! People are starting to clean up more than their garages, and many are at least considering eating more green things. The sales prices on asparagus and the thrill of a fiddlehead hunt (as long as we are able) is more motivation for the willing. For a lot of people, however, roughage can be uncomfortable additions to the spring-time diet.
Up to 50 million Americans are afflicted with a condition called Irritable Bowel Syndrome (IBS), and in the US. $10.5 billion is spent directly on its medical costs. While it’s not seen as a serious condition, it interrupts quality of life and is characterized by irregular bowel movements, abdominal discomfort, and various degrees of bloating and rectal urgency. Even worse, a lot of people suffer needlessly because, let’s be honest, bowel habits are not socially acceptable dinner conversation. As a result, most people don’t know that their “normal” may not actually be healthy. What we often fail to remember in the medical field is that the health of your digestive system is the foundation for the rest of your health. Your gut contains a majority of your immune system, and inflammation in the GI tract can trigger very significant systemic inflammatory responses. That’s why people with IBS often have comorbidities such as skin conditions and allergies.
So what do they believe causes IBS? There are a few theories, but I find treatment is really only effective if you look at all aspects of the condition. Some of the common trends in IBS are as follows:
Low diversity of gut bacteria: Typically the human digestive tract houses several species of lactobacillus, bifidobacterium, etc. Gut bacteria is there to help fight invading strains of bacteria, help you digest your food, and also work in concert with your immune system to maintain balance in your body. Many studies indicate that people with IBS don’t have as many different species, and there is increasing evidence that restoring gut bacteria can eliminate gas and distension in many sufferers.
Stress does affect the health of the GI tract: This is part of why even the most steadfast can suffer from diarrhea, constipation, or severe gas and bloating under stress. What we also know now is that anxiety and depression can actually increase intestinal permeability and inflammation, leading to IBS symptoms. Permeability means increased space between cells that are supposed to form a tight but absorptive wall lining the intestines. Like breaching a castle wall, holes in the GI lining allow food particles to escape into the bloodstream, which can cause your immune system to go haywire and mount a systemic attack. Gut bacteria, as mentioned above, are supposed to act as another protective layer against a “leaky gut,” so their presence is important for a number of reasons.
There is a very distinct branch of the nervous system in the digestive tract: Approximately 95% of serotonin, the neurotransmitter often targeted in depression and anxiety, is actually present in the digestive system. Improper neurotransmitter signaling in the gut may influences the gut lining hypersensitivity that can occur in IBS. This is also likely how stress in one’s every day life influences the actions of their bowels. Before you can effectively “go with your gut”, it would make sense to strive for a healthy gut!
Food sensitivities: While food allergies causing anaphylaxis are relatively rare (though incidence is rising), “leaky guts” allow food particles to escape the GI tract. This causes your immune system to “prime” itself against these foreign invaders, and can cause mild-severe sensitivity to the foods your immune cells “remember” as invaders. Again, this leads to inflammation and some of the unpleasantness of IBS.
Since IBS is stress inducing on its own and can be triggered by many things, it must be treated in a holistic way if success is desired. Some basic treatment methods that may be helpful include:
Addressing Food sensitivities: I usually start patients with a modified elimination diet with reintroduction to see what they react to. Some people don’t notice they are sensitive to something until they take it out of their diet for a few weeks then try eating it again. I find this to usually be more telling than expensive food sensitivity tests.
Exercising: Exercising helps with mechanical functions of the GI tract, moving things along and reducing constipation. It also reduces stress hormones like cortisol, and has a hand in managing neurotransmitters that may influence bowel function.
Food hygiene: Of course, wash your vegetables and cook your meat, but the phrase food hygiene actually refers to how you eat your food. I recommend that people eat slowly, chew their food, and that they don’t eat in front of computer and T.V. screens. Sitting in front of a screen jacks your sympathetic nervous response and increases stress hormones, which can negatively affect digestion.
Balancing gut bacteria: Eating the right kind of food is just as important if not more so than what probiotic supplement you use, because what you eat is what the bacteria eats and allows it to live. Eliminating sugar, refined carbohydrates, processed additives, yeasts, and some starches can be helpful. In the event of general supplementation, however, look for diverse bacterial combinations free of yeast, lactose, gluten, and soy. If you have specific digestive conditions, you may need more tailored probiotic advice, so consult a healthcare professional. Not all probiotics are created equally.
Stress management: A happy, relaxed body allows for proper gut function and elimination. I find breathing exercises and mindfulness meditation to be amazing tools. Even better; they’re free!
Botanicals: Teas have historically been used to aid with digestion, particularly common cooking and baking spices like mint, caraway, anise, fennel, etc. As with any product, always consult a healthcare provider before incorporating it into your routine.
Now, how do you know when it’s more than IBS? Remember to always see a healthcare professional if you are also experiencing weight loss, fever, overt blood in the stool, and frequent bowel movements at night. Also concerning would be abnormal lab results, family history of inflammatory bowel disease, family history of early colon cancer, and if these symptoms are starting after the age of 50. Your body knows when something is not right, so listen to it.
Any of this hard to digest? Leave a comment below or email Dr. Aline at arp.naturod@gmail.com.
*Disclaimer: The info in this column is meant as a public education tool and is not to be used for diagnostic purposes. Dr. Aline is more than happy to respond to general questions, but cannot provide individual diagnoses or treatment plans without taking full case history and physical exam. Thanks for reading, and stay engaged!
