Sitting in medical practice brings me in contact with people with a wide variety of symptoms and condition, though some things are commoner than others. One of the most common conditions I see is irritable bowel syndrome. This gut condition, characterised by one or more symptoms such as abdominal discomfort, bloating, wind, constipation and/or diarrhoea, is basically a ‘diagnosis of exclusion’. What this means is that, if deemed appropriate, individuals are assessed and investigated for know causes of gut symptoms such as inflammatory bowel disease (Crohn’s disease and ulcerative colitis). If the tests come back negative, then IBS is the diagnosis. Some would say it’s not really a diagnosis at all: it’s basically a doctor telling a patient that they have gut symptoms but he or she doesn’t know why.
This would not be so bad, I suppose, if the treatments for IBS were highly effective. Generally, though, they are not. And what this means is that many individuals suffer from what can be quite debilitating symptoms for years on end. The condition can be very uncomfortable, and the bloating can cause some (usually women) to complain of looking 5 months pregnant for much of the day. Some also suffer from ‘bowel urgency’, which means when they need to go they need to go, and this can blight some individuals’ lives because it necessitates them planning day-to-day activities and trips around available toilet facilities.
In conventional medicine, IBS is very often viewed as a condition that is stress-related. While this may be true, my experience in practice is that one or two nutritional approaches can usually either significantly improve symptoms or stop them altogether. Once successful, I find that stress or emotional upset is unlikely to provoke much in the way of symptoms.
The two approaches that I find work best for IBS are:
1. Identification and elimination of food triggers (wheat and dairy are common offenders in practice).
2. Correction of any underling imbalance there may be in the ‘ecosystem’ within the gut.
For a previous piece on IBS, as well as two previously published articles which explore these two approaches in more depth, see here.
One of the mainstay approaches I use in the treatment of IBS is probiotics: ‘healthy’ gut bacteria that may improve digestive health and also help to correct any imbalance in the gut’s ecosystem. Previous research has found that probiotics can help to relieve IBS symtoms, and this has certainly been my experience in practice. If I were restricted to using only one natural agent in the treatment of IBS, probiotics would be my choice.
I was reminded to write about this subject today because I read of a recently-published study which assessed the use of probiotics in individuals with IBS . 52 adults were treated with probiotics containing four strains of organism (2 types of lactobacillus and 2 types of bifidobacteria) or placebo for a period of 8 weeks. Compared to taking placebo, the probiotic preparation used in this study was found to significantly reduce the severity of IBS symptoms. Days with pain were reduced, and individuals experience and significantly improved quality of life and satisfaction with bowel habits.
Williams E, et al. Clinical trial: a multistrain probiotic preparation significantly reduces symptoms of irritable bowel syndrome in a double-blind placebo-controlled study. Aliment Pharmacol Ther. September 10 2008 [Epub ahead of print]